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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $60.26 Typical High $63.10 | Professional | None | $34.67 | $60.26 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $69.18 | Facility | None | $40.74 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $100.00 | Professional | None | $63.10 | $75.86 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $75.86 | Professional | None | $58.88 | $61.66 | $75.86 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $67.61 Typical High $309.03 | Facility | None | $41.69 | $67.61 | $309.03 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $57.54 Typical High $147.91 | Professional | None | $30.20 | $57.54 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $81.28 | Professional | None | $72.44 | $75.86 | $81.28 |
Midlands Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $102.33 Typical High $102.33 | Professional | None | $58.88 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $54.95 | Professional | None | $28.18 | $30.90 | $54.95 |
Wellmark Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $5.25 Median $9.12 Typical High $9.55 | Professional | 55 · Aftercare only | $5.25 | $9.12 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $6.03 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.47 | $6.03 | $6.31 |
Where Iowa sits
The same service costs 3.0 times more in Hawaii than in Rhode Island. 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· 10th of 51
$60.26
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.