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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $38.90 Typical High $39.81 | Professional | None | $21.88 | $38.90 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $44.67 Typical High $44.67 | Facility | None | $26.30 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $57.54 | Professional | None | $28.18 | $44.67 | $57.54 |
Hally Health Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $57.54 | Professional | None | $39.81 | $48.98 | $57.54 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $43.65 Typical High $186.21 | Facility | None | $26.92 | $43.65 | $186.21 |
Medica Setting Professional Modifier None Typical Low $19.05 Median $33.88 Typical High $85.11 | Professional | None | $19.05 | $33.88 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $45.71 | Professional | None | $44.67 | $44.67 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $33.88 Median $66.07 Typical High $66.07 | Professional | None | $33.88 | $66.07 | $66.07 |
United Setting Professional Modifier None Typical Low $16.22 Median $19.50 Typical High $34.67 | Professional | None | $16.22 | $19.50 | $34.67 |
Wellmark Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $3.31 Median $5.75 Typical High $5.89 | Professional | 55 · Aftercare only | $3.31 | $5.75 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.89 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.19 | $3.89 | $3.98 |
Where Iowa sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$38.90
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.