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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $6.46 Typical High $7.24 | Professional | None | $4.17 | $6.46 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $10.72 | Professional | None | $7.76 | $8.32 | $10.72 |
Hally Health Setting Professional Modifier None Typical Low $6.17 Median $7.24 Typical High $11.75 | Professional | None | $6.17 | $7.24 | $11.75 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $7.59 Typical High $8.71 | Facility | None | $4.57 | $7.59 | $8.71 |
Medica Setting Professional Modifier None Typical Low $3.31 Median $6.31 Typical High $37.15 | Professional | None | $3.31 | $6.31 | $37.15 |
Midlands Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $8.71 | Professional | None | $7.76 | $8.32 | $8.71 |
Midlands Setting Professional Modifier None Typical Low $6.46 Median $10.72 Typical High $16.22 | Professional | None | $6.46 | $10.72 | $16.22 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.31 Typical High $5.89 | Professional | None | $3.09 | $3.31 | $5.89 |
Wellmark Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
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 $0.83 Median $0.98 Typical High $1.07 | Professional | 55 · Aftercare only | $0.83 | $0.98 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.65 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.55 | $0.65 | $0.72 |
Where Iowa sits
The same service costs 2.5 times more in Idaho than in Colorado. 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· 9th of 51
$6.46
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.