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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $8.71 Typical High $8.91 | Professional | None | $4.37 | $8.71 | $8.91 |
Cigna Setting Facility Modifier None Typical Low $5.37 Median $10.00 Typical High $10.00 | Facility | None | $5.37 | $10.00 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $10.00 Typical High $12.02 | Professional | None | $8.91 | $10.00 | $12.02 |
Hally Health Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $11.22 | Professional | None | $7.59 | $8.91 | $11.22 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $9.77 Typical High $79.43 | Facility | None | $6.17 | $9.77 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.37 Median $7.59 Typical High $19.50 | Professional | None | $4.37 | $7.59 | $19.50 |
Midlands Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.47 | Professional | None | $10.00 | $10.00 | $10.47 |
Midlands Setting Professional Modifier None Typical Low $7.76 Median $15.14 Typical High $15.14 | Professional | None | $7.76 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $3.80 Median $4.47 Typical High $7.94 | Professional | None | $3.80 | $4.47 | $7.94 |
Wellmark Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | None | $7.24 | $7.24 | $7.24 |
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 $0.66 Median $1.32 Typical High $1.35 | Professional | 55 · Aftercare only | $0.66 | $1.32 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.87 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.44 | $0.87 | $0.89 |
Where Iowa sits
The same service costs 4.2 times more in Hawaii than in Kentucky. 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
$8.71
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.