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 $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.95 Typical High $2.34 | Professional | None | $1.32 | $1.95 | $2.34 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $2.24 Typical High $2.24 | Facility | None | $1.41 | $2.24 | $2.24 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $2.63 Typical High $3.31 | Professional | None | $2.04 | $2.63 | $3.31 |
Hally Health Setting Professional Modifier None Typical Low $2.00 Median $2.29 Typical High $3.55 | Professional | None | $2.00 | $2.29 | $3.55 |
Medica Setting Facility Modifier None Typical Low $1.38 Median $2.19 Typical High $79.43 | Facility | None | $1.38 | $2.19 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.00 Median $2.00 Typical High $5.13 | Professional | None | $1.00 | $2.00 | $5.13 |
Midlands Setting Professional Modifier None Typical Low $2.34 Median $2.63 Typical High $2.63 | Professional | None | $2.34 | $2.63 | $2.63 |
Midlands Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Facility | None | $2.24 | $2.24 | $2.24 |
Midlands Setting Professional Modifier None Typical Low $2.04 Median $3.31 Typical High $3.31 | Professional | None | $2.04 | $3.31 | $3.31 |
United Setting Professional Modifier None Typical Low $0.91 Median $1.00 Typical High $1.82 | Professional | None | $0.91 | $1.00 | $1.82 |
Wellmark Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
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 $0.20 Median $0.28 Typical High $0.35 | Professional | 55 · Aftercare only | $0.20 | $0.28 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.20 Typical High $0.23 | Professional | 56 · Pre-op care only | $0.13 | $0.20 | $0.23 |
Where Iowa sits
The same service costs 5.4 times more in Kansas than in Kentucky. 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· 13th of 51
$2.00
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.