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 $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier None Typical Low $3.63 Median $6.31 Typical High $6.46 | Professional | None | $3.63 | $6.31 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $7.24 Typical High $7.24 | Facility | None | $3.89 | $7.24 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $6.61 Median $7.24 Typical High $9.33 | Professional | None | $6.61 | $7.24 | $9.33 |
Hally Health Setting Professional Modifier None Typical Low $6.46 Median $8.13 Typical High $14.79 | Professional | None | $6.46 | $8.13 | $14.79 |
Medica Setting Facility Modifier None Typical Low $4.37 Median $7.08 Typical High $79.43 | Facility | None | $4.37 | $7.08 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.16 Median $5.50 Typical High $14.13 | Professional | None | $3.16 | $5.50 | $14.13 |
Midlands Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $7.59 | Professional | None | $7.24 | $7.24 | $7.59 |
Midlands Setting Professional Modifier None Typical Low $5.62 Median $10.72 Typical High $10.72 | Professional | None | $5.62 | $10.72 | $10.72 |
United Setting Professional Modifier None Typical Low $2.69 Median $3.24 Typical High $5.75 | Professional | None | $2.69 | $3.24 | $5.75 |
Wellmark Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
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 $0.54 Median $0.95 Typical High $0.98 | Professional | 55 · Aftercare only | $0.54 | $0.95 | $0.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.63 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.36 | $0.63 | $0.65 |
Where Iowa sits
The same service costs 2.6 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
$6.31
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.