How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $53.70 Median $61.66 Typical High $72.44 | Facility | None | $53.70 | $61.66 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $81.28 | Professional | None | $52.48 | $61.66 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $186.21 | Professional | None | $134.90 | $147.91 | $186.21 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $165.96 | Professional | None | $75.86 | $91.20 | $165.96 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $151.36 Typical High $371.54 | Facility | None | $83.18 | $151.36 | $371.54 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $186.21 | Professional | None | $77.62 | $112.20 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $154.88 Typical High $165.96 | Professional | None | $128.82 | $154.88 | $165.96 |
United Setting Professional Modifier None Typical Low $74.13 Median $85.11 Typical High $165.96 | Professional | None | $74.13 | $85.11 | $165.96 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | None | $100.00 | $100.00 | $117.49 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $28.18 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.51 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $7.24 | $7.24 |
Where Iowa sits
The same service costs 2.6 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Iowa· 16th of 51
$83.18
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.