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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $30.20 | Professional | None | $29.51 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $64.57 | Professional | None | $35.48 | $50.12 | $64.57 |
Hally Health Setting Professional Modifier None Typical Low $26.30 Median $30.90 Typical High $44.67 | Professional | None | $26.30 | $30.90 | $44.67 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $44.67 Typical High $77.62 | Facility | None | $36.31 | $44.67 | $77.62 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $51.29 Typical High $213.80 | Professional | None | $38.02 | $51.29 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Professional | None | $50.12 | $50.12 | $64.57 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $64.57 Typical High $89.13 | Professional | None | $63.10 | $64.57 | $89.13 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $79.43 | Professional | None | $33.11 | $43.65 | $79.43 |
Wellmark Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | None | $38.90 | $45.71 | $45.71 |
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 $14.79 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $14.79 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.89 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.95 | $3.02 | $3.02 |
Where Iowa sits
The same service costs 3.0 times more in Alaska than in New York. 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· 9th of 51
$45.71
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.