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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $13.18 Typical High $13.49 | Professional | None | $6.92 | $13.18 | $13.49 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $15.14 Typical High $15.14 | Facility | None | $8.13 | $15.14 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $15.14 Typical High $19.05 | Professional | None | $13.80 | $15.14 | $19.05 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $13.49 Typical High $20.42 | Professional | None | $12.88 | $13.49 | $20.42 |
Medica Setting Facility Modifier None Typical Low $9.12 Median $14.79 Typical High $79.43 | Facility | None | $9.12 | $14.79 | $79.43 |
Medica Setting Professional Modifier None Typical Low $6.61 Median $11.48 Typical High $29.51 | Professional | None | $6.61 | $11.48 | $29.51 |
Midlands Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | None | $15.14 | $15.14 | $15.85 |
Midlands Setting Professional Modifier None Typical Low $11.48 Median $22.39 Typical High $22.39 | Professional | None | $11.48 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $5.62 Median $6.76 Typical High $11.75 | Professional | None | $5.62 | $6.76 | $11.75 |
Wellmark Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
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 $1.12 Median $1.95 Typical High $2.00 | Professional | 55 · Aftercare only | $1.12 | $1.95 | $2.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $1.32 Typical High $1.35 | Professional | 56 · Pre-op care only | $0.76 | $1.32 | $1.35 |
Where Iowa sits
The same service costs 2.1 times more in Hawaii than in Colorado. 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
$13.18
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.