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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $4.79 Typical High $4.79 | Professional | None | $2.29 | $4.79 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $5.50 Typical High $5.50 | Facility | None | $2.95 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $7.08 | Professional | None | $5.01 | $5.50 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $6.31 | Professional | None | $4.27 | $4.79 | $6.31 |
Medica Setting Facility Modifier None Typical Low $3.31 Median $5.37 Typical High $79.43 | Facility | None | $3.31 | $5.37 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.34 Median $4.17 Typical High $10.47 | Professional | None | $2.34 | $4.17 | $10.47 |
Midlands Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.62 | Professional | None | $5.50 | $5.50 | $5.62 |
Midlands Setting Professional Modifier None Typical Low $4.17 Median $8.13 Typical High $8.13 | Professional | None | $4.17 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.40 Typical High $4.27 | Professional | None | $2.00 | $2.40 | $4.27 |
Wellmark Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
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 $0.36 Median $0.71 Typical High $0.72 | Professional | 55 · Aftercare only | $0.36 | $0.71 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.48 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.24 | $0.48 | $0.49 |
Where Iowa sits
The same service costs 5.5 times more in Kansas than in Delaware. 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· 7th of 51
$4.68
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.