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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $42.66 Typical High $43.65 | Professional | None | $24.55 | $42.66 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $63.10 | Professional | None | $47.86 | $48.98 | $63.10 |
Hally Health Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $66.07 | Professional | None | $33.11 | $43.65 | $66.07 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $47.86 Typical High $56.23 | Facility | None | $29.51 | $47.86 | $56.23 |
Medica Setting Professional Modifier None Typical Low $15.14 Median $36.31 Typical High $213.80 | Professional | None | $15.14 | $36.31 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | None | $48.98 | $48.98 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $93.33 | Professional | None | $37.15 | $61.66 | $93.33 |
United Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | None | $15.14 | $15.14 | $15.85 |
Wellmark Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $15.85 Median $21.38 Typical High $21.88 | Professional | 52 · Reduced service | $15.85 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $8.51 Typical High $8.71 | Professional | 53 · Discontinued | $6.46 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $4.79 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $4.27 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.24 | $4.27 | $4.37 |
Where Iowa sits
The same service costs 3.2 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· 7th of 51
$42.66
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.