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 $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $3.72 Typical High $3.80 | Professional | None | $1.78 | $3.72 | $3.80 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $4.27 Typical High $4.27 | Facility | None | $2.29 | $4.27 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $5.62 | Professional | None | $3.89 | $4.27 | $5.62 |
Hally Health Setting Professional Modifier None Typical Low $3.80 Median $4.17 Typical High $4.90 | Professional | None | $3.80 | $4.17 | $4.90 |
Medica Setting Facility Modifier None Typical Low $2.57 Median $4.17 Typical High $79.43 | Facility | None | $2.57 | $4.17 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.86 Median $3.24 Typical High $8.13 | Professional | None | $1.86 | $3.24 | $8.13 |
Midlands Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | None | $4.27 | $4.27 | $4.47 |
Midlands Setting Professional Modifier None Typical Low $3.24 Median $6.31 Typical High $6.31 | Professional | None | $3.24 | $6.31 | $6.31 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.86 Typical High $3.31 | Professional | None | $1.58 | $1.86 | $3.31 |
Wellmark Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | None | $3.09 | $3.09 | $3.09 |
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 $0.32 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.32 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.37 Typical High $0.38 | Professional | 56 · Pre-op care only | $0.21 | $0.37 | $0.38 |
Where Iowa sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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
$3.72
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.