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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $11.75 Typical High $12.02 | Professional | None | $6.61 | $11.75 | $12.02 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $13.49 Typical High $13.49 | Facility | None | $7.08 | $13.49 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $12.30 Median $13.49 Typical High $17.38 | Professional | None | $12.30 | $13.49 | $17.38 |
Hally Health Setting Professional Modifier None Typical Low $11.48 Median $12.02 Typical High $19.05 | Professional | None | $11.48 | $12.02 | $19.05 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $13.18 Typical High $79.43 | Facility | None | $8.13 | $13.18 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $10.23 Typical High $25.70 | Professional | None | $5.75 | $10.23 | $25.70 |
Midlands Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $13.80 | Professional | None | $13.49 | $13.49 | $13.80 |
Midlands Setting Professional Modifier None Typical Low $10.23 Median $19.95 Typical High $19.95 | Professional | None | $10.23 | $19.95 | $19.95 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.89 Typical High $10.47 | Professional | None | $4.90 | $5.89 | $10.47 |
Wellmark Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
4 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 52 · Reduced service Typical Low $3.31 Median $5.89 Typical High $5.89 | Professional | 52 · Reduced service | $3.31 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $2.34 Typical High $2.40 | Professional | 53 · Discontinued | $1.35 | $2.34 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.74 Typical High $1.78 | Professional | 55 · Aftercare only | $1.00 | $1.74 | $1.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.17 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.68 | $1.17 | $1.20 |
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· 5th of 51
$11.75
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.