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 $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier None Typical Low $3.31 Median $5.75 Typical High $5.89 | Professional | None | $3.31 | $5.75 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $6.61 Typical High $6.61 | Facility | None | $3.80 | $6.61 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $6.61 Typical High $8.51 | Professional | None | $4.27 | $6.61 | $8.51 |
Hally Health Setting Professional Modifier None Typical Low $5.89 Median $7.24 Typical High $13.18 | Professional | None | $5.89 | $7.24 | $13.18 |
Medica Setting Facility Modifier None Typical Low $3.98 Median $6.46 Typical High $79.43 | Facility | None | $3.98 | $6.46 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.88 Median $5.01 Typical High $12.88 | Professional | None | $2.88 | $5.01 | $12.88 |
Midlands Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.92 | Professional | None | $6.61 | $6.61 | $6.92 |
Midlands Setting Professional Modifier None Typical Low $5.01 Median $9.77 Typical High $9.77 | Professional | None | $5.01 | $9.77 | $9.77 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.95 Typical High $5.13 | Professional | None | $2.40 | $2.95 | $5.13 |
Wellmark Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
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 $0.49 Median $0.85 Typical High $0.87 | Professional | 55 · Aftercare only | $0.49 | $0.85 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.58 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.33 | $0.58 | $0.59 |
Where Iowa sits
The same service costs 3.2 times more in Kansas than in New Hampshire. 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
$5.75
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.