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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $4.68 Median $8.13 Typical High $8.32 | Professional | None | $4.68 | $8.13 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $9.33 Typical High $9.33 | Facility | None | $5.01 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $12.30 | Professional | None | $8.71 | $9.33 | $12.30 |
Hally Health Setting Professional Modifier None Typical Low $8.32 Median $10.23 Typical High $12.02 | Professional | None | $8.32 | $10.23 | $12.02 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $9.12 Typical High $79.43 | Facility | None | $5.75 | $9.12 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.07 Median $7.24 Typical High $18.20 | Professional | None | $4.07 | $7.24 | $18.20 |
Midlands Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $9.77 | Professional | None | $9.33 | $9.33 | $9.77 |
Midlands Setting Professional Modifier None Typical Low $7.24 Median $14.13 Typical High $14.13 | Professional | None | $7.24 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $7.41 | Professional | None | $3.47 | $4.17 | $7.41 |
Wellmark Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
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 $0.71 Median $1.23 Typical High $1.26 | Professional | 55 · Aftercare only | $0.71 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.47 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.47 | $0.81 | $0.83 |
Where Iowa sits
The same service costs 2.1 times more in Hawaii 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· 7th of 51
$8.13
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.