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 $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.78 | Professional | None | $1.74 | $1.74 | $1.78 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $3.02 Typical High $4.17 | Professional | None | $2.24 | $3.02 | $4.17 |
Hally Health Setting Professional Modifier None Typical Low $7.41 Median $7.94 Typical High $199.53 | Professional | None | $7.41 | $7.94 | $199.53 |
Medica Setting Facility Modifier None Typical Low $2.19 Median $2.51 Typical High $4.79 | Facility | None | $2.19 | $2.51 | $4.79 |
Medica Setting Professional Modifier None Typical Low $1.17 Median $2.51 Typical High $17.78 | Professional | None | $1.17 | $2.51 | $17.78 |
Midlands Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $4.79 | Professional | None | $3.02 | $3.02 | $4.79 |
Midlands Setting Professional Modifier None Typical Low $3.39 Median $4.07 Typical High $5.50 | Professional | None | $3.39 | $4.07 | $5.50 |
United Setting Professional Modifier None Typical Low $1.15 Median $1.17 Typical High $2.09 | Professional | None | $1.15 | $1.17 | $2.09 |
Wellmark Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | None | $2.75 | $2.75 | $2.75 |
2 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 55 · Aftercare only Typical Low $0.26 Median $0.26 Typical High $0.27 | Professional | 55 · Aftercare only | $0.26 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.18 |
Where Iowa sits
The same service costs 6.6 times more in Kentucky than in West Virginia. 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· 11th of 51
$2.51
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.