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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $52.48 Typical High $53.70 | Professional | None | $26.30 | $52.48 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $60.26 Typical High $60.26 | Facility | None | $35.48 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $72.44 Typical High $77.62 | Professional | None | $58.88 | $72.44 | $77.62 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $75.86 | Professional | None | $50.12 | $53.70 | $75.86 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $58.88 Typical High $251.19 | Facility | None | $39.81 | $58.88 | $251.19 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $46.77 Typical High $173.78 | Professional | None | $26.92 | $46.77 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | None | $63.10 | $72.44 | $72.44 |
Midlands Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.92 Typical High $47.86 | Professional | None | $24.55 | $26.92 | $47.86 |
Wellmark Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
4 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 52 · Reduced service Typical Low $15.14 Median $26.30 Typical High $26.92 | Professional | 52 · Reduced service | $15.14 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $6.03 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $7.94 Typical High $8.13 | Professional | 55 · Aftercare only | $4.57 | $7.94 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $5.25 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.02 | $5.25 | $5.37 |
Where Iowa sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 4th of 51
$53.70
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.