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 $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $9.55 Typical High $9.55 | Professional | None | $6.76 | $9.55 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $16.60 Typical High $20.89 | Professional | None | $9.33 | $16.60 | $20.89 |
Hally Health Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $309.03 | Professional | None | $218.78 | $239.88 | $309.03 |
Medica Setting Facility Modifier None Typical Low $12.59 Median $13.80 Typical High $25.12 | Facility | None | $12.59 | $13.80 | $25.12 |
Medica Setting Professional Modifier None Typical Low $6.46 Median $15.85 Typical High $89.13 | Professional | None | $6.46 | $15.85 | $89.13 |
Midlands Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $26.30 | Professional | None | $16.60 | $16.60 | $26.30 |
Midlands Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $27.54 | Professional | None | $13.80 | $22.39 | $27.54 |
United Setting Professional Modifier None Typical Low $6.03 Median $6.46 Typical High $11.48 | Professional | None | $6.03 | $6.46 | $11.48 |
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 $1.02 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.02 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.68 | $0.95 | $0.95 |
Where Iowa sits
The same service costs 95.5 times more in New York 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· 5th of 51
$13.18
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.