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 $2.19 Median $2.19 Typical High $2.19 | Facility | None | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier None Typical Low $0.95 Median $2.14 Typical High $2.19 | Professional | None | $0.95 | $2.14 | $2.19 |
Cigna Setting Facility Modifier None Typical Low $0.72 Median $2.51 Typical High $2.51 | Facility | None | $0.72 | $2.51 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.51 Typical High $3.31 | Professional | None | $2.29 | $2.51 | $3.31 |
Hally Health Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $2.95 | Professional | None | $1.91 | $2.24 | $2.95 |
Medica Setting Facility Modifier None Typical Low $1.51 Median $2.45 Typical High $79.43 | Facility | None | $1.51 | $2.45 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.07 Median $1.91 Typical High $4.79 | Professional | None | $1.07 | $1.91 | $4.79 |
Midlands Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.57 | Professional | None | $2.51 | $2.51 | $2.57 |
Midlands Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Midlands Setting Professional Modifier None Typical Low $1.91 Median $3.72 Typical High $3.72 | Professional | None | $1.91 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $0.93 Median $1.12 Typical High $1.95 | Professional | None | $0.93 | $1.12 | $1.95 |
Wellmark Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
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 $0.16 Median $0.32 Typical High $0.33 | Professional | 55 · Aftercare only | $0.16 | $0.32 | $0.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.21 Typical High $0.22 | Professional | 56 · Pre-op care only | $0.11 | $0.21 | $0.22 |
Where Iowa sits
The same service costs 5.8 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· 5th of 51
$2.14
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.