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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $24.55 Typical High $25.12 | Professional | None | $13.49 | $24.55 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $12.02 Median $28.18 Typical High $28.18 | Facility | None | $12.02 | $28.18 | $28.18 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $28.18 Typical High $36.31 | Professional | None | $25.70 | $28.18 | $36.31 |
Hally Health Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $33.11 | Professional | None | $24.55 | $27.54 | $33.11 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $27.54 Typical High $112.20 | Facility | None | $17.38 | $27.54 | $112.20 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $21.38 Typical High $54.95 | Professional | None | $12.30 | $21.38 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | None | $28.18 | $28.18 | $29.51 |
Midlands Setting Professional Modifier None Typical Low $21.88 Median $42.66 Typical High $42.66 | Professional | None | $21.88 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $22.39 | Professional | None | $10.72 | $12.59 | $22.39 |
Wellmark Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
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 $2.04 Median $3.72 Typical High $3.80 | Professional | 55 · Aftercare only | $2.04 | $3.72 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.35 | $2.45 | $2.51 |
Where Iowa sits
The same service costs 3.5 times more in Hawaii than in Connecticut. 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· 5th of 51
$24.55
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.