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 $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier None Typical Low $2.75 Median $4.79 Typical High $4.90 | Professional | None | $2.75 | $4.79 | $4.90 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $5.50 Typical High $5.50 | Facility | None | $2.95 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.50 Typical High $7.08 | Professional | None | $5.13 | $5.50 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $4.90 Median $5.01 Typical High $7.59 | Professional | None | $4.90 | $5.01 | $7.59 |
Medica Setting Facility Modifier None Typical Low $3.39 Median $5.37 Typical High $79.43 | Facility | None | $3.39 | $5.37 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.40 Median $4.27 Typical High $10.72 | Professional | None | $2.40 | $4.27 | $10.72 |
Midlands Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.75 | Professional | None | $5.50 | $5.50 | $5.75 |
Midlands Setting Professional Modifier None Typical Low $4.27 Median $8.32 Typical High $8.32 | Professional | None | $4.27 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.45 Typical High $4.37 | Professional | None | $2.04 | $2.45 | $4.37 |
Wellmark Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | None | $4.07 | $4.07 | $4.07 |
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 $0.42 Median $0.72 Typical High $0.74 | Professional | 55 · Aftercare only | $0.42 | $0.72 | $0.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.48 Typical High $0.49 | Professional | 56 · Pre-op care only | $0.28 | $0.48 | $0.49 |
Where Iowa sits
The same service costs 2.1 times more in Montana than in Colorado. 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
$4.79
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.