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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | None | $102.33 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $223.87 | Professional | None | $123.03 | $177.83 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $147.91 | Professional | None | $91.20 | $107.15 | $147.91 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $269.15 | Facility | None | $125.89 | $151.36 | $269.15 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $741.31 | Professional | None | $131.83 | $177.83 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $223.87 | Professional | None | $177.83 | $177.83 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $302.00 | Professional | None | $218.78 | $223.87 | $302.00 |
United Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $269.15 | Professional | None | $112.20 | $147.91 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | None | $138.04 | $162.18 | $162.18 |
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 $51.29 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $51.29 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.42 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $10.47 |
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
$162
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.