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 $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $11.22 Typical High $11.48 | Professional | None | $6.46 | $11.22 | $11.48 |
Cigna Setting Facility Modifier None Typical Low $6.92 Median $12.88 Typical High $12.88 | Facility | None | $6.92 | $12.88 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $12.88 Typical High $16.60 | Professional | None | $11.75 | $12.88 | $16.60 |
Hally Health Setting Professional Modifier None Typical Low $11.48 Median $14.45 Typical High $18.20 | Professional | None | $11.48 | $14.45 | $18.20 |
Medica Setting Facility Modifier None Typical Low $7.76 Median $12.59 Typical High $79.43 | Facility | None | $7.76 | $12.59 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.62 Median $9.77 Typical High $24.55 | Professional | None | $5.62 | $9.77 | $24.55 |
Midlands Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | None | $12.88 | $12.88 | $13.49 |
Midlands Setting Professional Modifier None Typical Low $9.77 Median $19.05 Typical High $19.05 | Professional | None | $9.77 | $19.05 | $19.05 |
United Setting Professional Modifier None Typical Low $4.79 Median $5.75 Typical High $10.00 | Professional | None | $4.79 | $5.75 | $10.00 |
Wellmark Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | None | $9.33 | $9.33 | $9.33 |
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 $0.95 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $0.95 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $0.65 | $1.12 | $1.12 |
Where Iowa sits
The same service costs 2.1 times more in Idaho 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· 4th of 51
$11.22
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.