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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $36.31 Typical High $37.15 | Professional | None | $19.95 | $36.31 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $41.69 Typical High $41.69 | Facility | None | $18.20 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $53.70 | Professional | None | $38.02 | $41.69 | $53.70 |
Hally Health Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $85.11 | Professional | None | $37.15 | $45.71 | $85.11 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $40.74 Typical High $165.96 | Facility | None | $25.12 | $40.74 | $165.96 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $31.62 Typical High $79.43 | Professional | None | $18.20 | $31.62 | $79.43 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $42.66 | Professional | None | $41.69 | $41.69 | $42.66 |
Midlands Setting Professional Modifier None Typical Low $31.62 Median $61.66 Typical High $61.66 | Professional | None | $31.62 | $61.66 | $61.66 |
United Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $32.36 | Professional | None | $15.49 | $18.20 | $32.36 |
Wellmark Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $2.95 Median $5.37 Typical High $5.50 | Professional | 55 · Aftercare only | $2.95 | $5.37 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $3.63 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.00 | $3.63 | $3.72 |
Where Iowa sits
The same service costs 2.9 times more in Hawaii than in Rhode Island. 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· 4th of 51
$36.31
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.