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 $13.49 Median $13.49 Typical High $13.49 | Facility | None | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $13.49 Typical High $13.80 | Professional | None | $7.76 | $13.49 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $8.32 Median $15.49 Typical High $15.49 | Facility | None | $8.32 | $15.49 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $15.49 Typical High $19.95 | Professional | None | $14.13 | $15.49 | $19.95 |
Hally Health Setting Professional Modifier None Typical Low $13.49 Median $15.14 Typical High $18.62 | Professional | None | $13.49 | $15.14 | $18.62 |
Medica Setting Facility Modifier None Typical Low $9.33 Median $15.14 Typical High $79.43 | Facility | None | $9.33 | $15.14 | $79.43 |
Medica Setting Professional Modifier None Typical Low $6.76 Median $11.75 Typical High $30.20 | Professional | None | $6.76 | $11.75 | $30.20 |
Midlands Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | None | $15.49 | $15.49 | $16.22 |
Midlands Setting Professional Modifier None Typical Low $11.75 Median $22.91 Typical High $22.91 | Professional | None | $11.75 | $22.91 | $22.91 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $12.02 | Professional | None | $5.75 | $6.92 | $12.02 |
Wellmark Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
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 $1.15 Median $2.04 Typical High $2.04 | Professional | 55 · Aftercare only | $1.15 | $2.04 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.35 Typical High $1.38 | Professional | 56 · Pre-op care only | $0.78 | $1.35 | $1.38 |
Where Iowa sits
The same service costs 2.1 times more in Idaho than in Delaware. 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
$13.49
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.