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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $5.50 Median $9.55 Typical High $9.77 | Professional | None | $5.50 | $9.55 | $9.77 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $10.96 Typical High $10.96 | Facility | None | $5.89 | $10.96 | $10.96 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $10.96 Typical High $14.13 | Professional | None | $10.00 | $10.96 | $14.13 |
Hally Health Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $13.80 | Professional | None | $9.77 | $10.72 | $13.80 |
Medica Setting Facility Modifier None Typical Low $6.61 Median $10.72 Typical High $79.43 | Facility | None | $6.61 | $10.72 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.79 Median $8.32 Typical High $21.38 | Professional | None | $4.79 | $8.32 | $21.38 |
Midlands Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $11.48 | Professional | None | $10.96 | $10.96 | $11.48 |
Midlands Setting Professional Modifier None Typical Low $8.51 Median $16.22 Typical High $16.22 | Professional | None | $8.51 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $8.71 | Professional | None | $4.17 | $4.90 | $8.71 |
Wellmark Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
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 $0.81 Median $1.45 Typical High $1.48 | Professional | 55 · Aftercare only | $0.81 | $1.45 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.55 Median $0.95 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.55 | $0.95 | $0.98 |
Where Iowa sits
The same service costs 2.4 times more in Kansas 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· 6th of 51
$9.55
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.