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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $10.72 Median $21.88 Typical High $22.39 | Professional | None | $10.72 | $21.88 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $9.55 Median $25.12 Typical High $25.12 | Facility | None | $9.55 | $25.12 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $30.90 | Professional | None | $22.91 | $25.12 | $30.90 |
Hally Health Setting Professional Modifier None Typical Low $19.05 Median $24.55 Typical High $29.51 | Professional | None | $19.05 | $24.55 | $29.51 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $24.55 Typical High $102.33 | Facility | None | $15.14 | $24.55 | $102.33 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $19.05 Typical High $48.98 | Professional | None | $10.96 | $19.05 | $48.98 |
Midlands Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.30 | Professional | None | $25.12 | $25.12 | $26.30 |
Midlands Setting Professional Modifier None Typical Low $19.05 Median $37.15 Typical High $37.15 | Professional | None | $19.05 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $9.55 Median $11.22 Typical High $19.50 | Professional | None | $9.55 | $11.22 | $19.50 |
Wellmark Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
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 $1.62 Median $3.31 Typical High $3.39 | Professional | 55 · Aftercare only | $1.62 | $3.31 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.07 Median $2.19 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.07 | $2.19 | $2.24 |
Where Iowa sits
The same service costs 2.8 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· 4th of 51
$21.88
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.