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 $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $10.47 Typical High $12.59 | Professional | None | $6.17 | $10.47 | $12.59 |
Cigna Setting Facility Modifier None Typical Low $4.90 Median $12.02 Typical High $12.02 | Facility | None | $4.90 | $12.02 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $17.78 | Professional | None | $11.22 | $14.13 | $17.78 |
Hally Health Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $21.88 | Professional | None | $10.72 | $12.59 | $21.88 |
Medica Setting Facility Modifier None Typical Low $7.24 Median $12.02 Typical High $79.43 | Facility | None | $7.24 | $12.02 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $10.47 Typical High $26.92 | Professional | None | $5.25 | $10.47 | $26.92 |
Midlands Setting Professional Modifier None Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | None | $12.59 | $14.13 | $14.13 |
Midlands Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Midlands Setting Professional Modifier None Typical Low $10.72 Median $17.78 Typical High $17.78 | Professional | None | $10.72 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $9.33 | Professional | None | $5.25 | $5.25 | $9.33 |
Wellmark Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $0.91 Median $1.55 Typical High $1.86 | Professional | 55 · Aftercare only | $0.91 | $1.55 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $1.05 Typical High $1.26 | Professional | 56 · Pre-op care only | $0.62 | $1.05 | $1.26 |
Where Iowa sits
The same service costs 5.0 times more in Hawaii than in Rhode Island. 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· 10th of 51
$10.47
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.