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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | None | $45.71 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $102.33 | Professional | None | $54.95 | $79.43 | $102.33 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $70.79 | Professional | None | $40.74 | $47.86 | $70.79 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $67.61 Typical High $123.03 | Facility | None | $56.23 | $67.61 | $123.03 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $331.13 | Professional | None | $58.88 | $79.43 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $102.33 | Professional | None | $79.43 | $79.43 | $102.33 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $102.33 Typical High $134.90 | Professional | None | $100.00 | $102.33 | $134.90 |
United Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $120.23 | Professional | None | $50.12 | $67.61 | $120.23 |
Wellmark Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | None | $61.66 | $72.44 | $72.44 |
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 $22.91 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $22.91 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $9.12 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.92 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.57 | $4.68 | $4.68 |
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· 8th of 51
$72.44
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.