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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $6.46 Typical High $6.61 | Professional | None | $3.55 | $6.46 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $7.41 Typical High $7.41 | Facility | None | $3.98 | $7.41 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $7.41 Typical High $9.33 | Professional | None | $6.76 | $7.41 | $9.33 |
Hally Health Setting Professional Modifier None Typical Low $5.62 Median $6.61 Typical High $12.30 | Professional | None | $5.62 | $6.61 | $12.30 |
Medica Setting Facility Modifier None Typical Low $4.47 Median $7.24 Typical High $79.43 | Facility | None | $4.47 | $7.24 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $5.62 Typical High $14.45 | Professional | None | $3.24 | $5.62 | $14.45 |
Midlands Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.76 | Professional | None | $7.41 | $7.41 | $7.76 |
Midlands Setting Professional Modifier None Typical Low $5.62 Median $10.96 Typical High $10.96 | Professional | None | $5.62 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.31 Typical High $5.75 | Professional | None | $2.82 | $3.31 | $5.75 |
Wellmark Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
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 $0.52 Median $0.98 Typical High $1.00 | Professional | 55 · Aftercare only | $0.52 | $0.98 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.65 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.36 | $0.65 | $0.66 |
Where Iowa sits
The same service costs 2.2 times more in Minnesota than in Connecticut. 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· 3rd of 51
$6.31
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.