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 $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $12.30 Typical High $12.59 | Professional | None | $7.08 | $12.30 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $14.13 Typical High $14.13 | Facility | None | $7.59 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $18.20 | Professional | None | $12.88 | $14.13 | $18.20 |
Hally Health Setting Professional Modifier None Typical Low $12.59 Median $13.80 Typical High $19.50 | Professional | None | $12.59 | $13.80 | $19.50 |
Medica Setting Facility Modifier None Typical Low $8.71 Median $13.80 Typical High $79.43 | Facility | None | $8.71 | $13.80 | $79.43 |
Medica Setting Professional Modifier None Typical Low $6.17 Median $10.72 Typical High $27.54 | Professional | None | $6.17 | $10.72 | $27.54 |
Midlands Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | None | $14.13 | $14.13 | $14.79 |
Midlands Setting Professional Modifier None Typical Low $10.96 Median $21.38 Typical High $21.38 | Professional | None | $10.96 | $21.38 | $21.38 |
United Setting Professional Modifier None Typical Low $5.25 Median $6.31 Typical High $11.22 | Professional | None | $5.25 | $6.31 | $11.22 |
Wellmark Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | None | $10.23 | $10.23 | $10.23 |
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 $1.07 Median $1.86 Typical High $1.91 | Professional | 55 · Aftercare only | $1.07 | $1.86 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $1.23 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.71 | $1.23 | $1.26 |
Where Iowa sits
The same service costs 2.1 times more in Idaho than in Connecticut. 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· 6th of 51
$12.30
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.