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 $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $9.33 Typical High $10.23 | Professional | None | $5.01 | $9.33 | $10.23 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $10.47 Typical High $10.47 | Facility | None | $6.17 | $10.47 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $15.14 | Professional | None | $9.77 | $11.48 | $15.14 |
Hally Health Setting Professional Modifier None Typical Low $9.33 Median $10.23 Typical High $17.38 | Professional | None | $9.33 | $10.23 | $17.38 |
Medica Setting Facility Modifier None Typical Low $6.46 Median $10.47 Typical High $79.43 | Facility | None | $6.46 | $10.47 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.68 Median $8.71 Typical High $22.39 | Professional | None | $4.68 | $8.71 | $22.39 |
Midlands Setting Professional Modifier None Typical Low $10.96 Median $11.48 Typical High $12.59 | Professional | None | $10.96 | $11.48 | $12.59 |
Midlands Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Midlands Setting Professional Modifier None Typical Low $8.91 Median $15.85 Typical High $15.85 | Professional | None | $8.91 | $15.85 | $15.85 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.68 Typical High $8.32 | Professional | None | $4.27 | $4.68 | $8.32 |
Wellmark Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
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 $0.83 Median $1.38 Typical High $1.55 | Professional | 55 · Aftercare only | $0.83 | $1.38 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.91 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.56 | $0.91 | $1.02 |
Where Iowa sits
The same service costs 2.1 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· 10th of 51
$9.33
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.