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 $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $6.76 Typical High $6.92 | Professional | None | $3.89 | $6.76 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $7.76 Typical High $7.76 | Facility | None | $3.16 | $7.76 | $7.76 |
Cigna Setting Professional Modifier None Typical Low $7.08 Median $7.76 Typical High $9.77 | Professional | None | $7.08 | $7.76 | $9.77 |
Hally Health Setting Professional Modifier None Typical Low $6.61 Median $6.92 Typical High $8.71 | Professional | None | $6.61 | $6.92 | $8.71 |
Medica Setting Facility Modifier None Typical Low $4.68 Median $7.59 Typical High $79.43 | Facility | None | $4.68 | $7.59 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.39 Median $5.89 Typical High $14.79 | Professional | None | $3.39 | $5.89 | $14.79 |
Midlands Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $8.13 | Professional | None | $7.76 | $7.76 | $8.13 |
Midlands Setting Professional Modifier None Typical Low $5.89 Median $11.48 Typical High $11.48 | Professional | None | $5.89 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $2.95 Median $3.47 Typical High $6.03 | Professional | None | $2.95 | $3.47 | $6.03 |
Wellmark Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | None | $5.62 | $5.62 | $5.62 |
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 $0.58 Median $1.00 Typical High $1.02 | Professional | 55 · Aftercare only | $0.58 | $1.00 | $1.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.68 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.39 | $0.68 | $0.69 |
Where Iowa sits
The same service costs 2.1 times more in Idaho 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· 4th of 51
$6.76
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.