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 $9.77 Median $9.77 Typical High $38.90 | Facility | None | $9.77 | $9.77 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $7.08 Median $9.77 Typical High $10.00 | Professional | None | $7.08 | $9.77 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $16.98 Typical High $26.92 | Professional | None | $9.77 | $16.98 | $26.92 |
Hally Health Setting Professional Modifier None Typical Low $32.36 Median $42.66 Typical High $151.36 | Professional | None | $32.36 | $42.66 | $151.36 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $20.89 Typical High $38.02 | Facility | None | $14.13 | $20.89 | $38.02 |
Medica Setting Professional Modifier None Typical Low $6.61 Median $16.60 Typical High $74.13 | Professional | None | $6.61 | $16.60 | $74.13 |
Midlands Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $28.18 | Professional | None | $16.98 | $16.98 | $28.18 |
Midlands Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $28.18 | Professional | None | $18.20 | $28.18 | $28.18 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $6.17 Median $6.61 Typical High $11.75 | Professional | None | $6.17 | $6.61 | $11.75 |
Wellmark Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Wellmark Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $3.55 Median $4.90 Typical High $5.01 | Professional | 52 · Reduced service | $3.55 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.95 Typical High $2.04 | Professional | 53 · Discontinued | $1.41 | $1.95 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.48 Typical High $1.51 | Professional | 55 · Aftercare only | $1.05 | $1.48 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.98 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.71 | $0.98 | $1.00 |
Where Iowa sits
The same service costs 46.8 times more in New York than in Arkansas. 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
$16.98
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.