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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $134.90 | Professional | None | $93.33 | $109.65 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $165.96 | Professional | None | $117.49 | $147.91 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $147.91 | Professional | None | $95.50 | $100.00 | $147.91 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $181.97 Typical High $537.03 | Facility | None | $107.15 | $181.97 | $537.03 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $275.42 | Professional | None | $141.25 | $186.21 | $275.42 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $288.40 | Professional | None | $131.83 | $213.80 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | None | $128.82 | $128.82 | $151.36 |
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 $46.77 Median $54.95 Typical High $67.61 | Professional | 52 · Reduced service | $46.77 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $18.62 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $14.13 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $13.49 |
Where Iowa sits
The same service costs 3.0 times more in Alaska than in West Virginia. 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· 13th of 51
$145
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.