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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $100.00 Typical High $100.00 | Professional | None | $54.95 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $120.23 Typical High $120.23 | Facility | None | $64.57 | $120.23 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $147.91 | Professional | None | $107.15 | $120.23 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $131.83 | Professional | None | $89.13 | $93.33 | $131.83 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $120.23 Typical High $426.58 | Facility | None | $63.10 | $120.23 | $426.58 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $120.23 Typical High $478.63 | Professional | None | $48.98 | $120.23 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | None | $120.23 | $120.23 | $128.82 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $295.12 | Professional | None | $128.82 | $128.82 | $295.12 |
United Setting Professional Modifier None Typical Low $45.71 Median $48.98 Typical High $87.10 | Professional | None | $45.71 | $48.98 | $87.10 |
Wellmark Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
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 $27.54 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $27.54 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $10.96 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $8.32 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.50 | $10.00 | $10.00 |
Where Iowa sits
The same service costs 2.5 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· 3rd of 51
$110
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.