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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $66.07 | Professional | None | $51.29 | $56.23 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $131.83 | Professional | None | $66.07 | $83.18 | $131.83 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $69.18 Typical High $213.80 | Facility | None | $57.54 | $69.18 | $213.80 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $363.08 | Professional | None | $69.18 | $100.00 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | None | $83.18 | $83.18 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $151.36 | Professional | None | $69.18 | $131.83 | $151.36 |
United Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $169.82 | Professional | None | $60.26 | $95.50 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
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 $25.70 Median $28.18 Typical High $33.11 | Professional | 52 · Reduced service | $25.70 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.22 Typical High $13.18 | Professional | 53 · Discontinued | $10.23 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $10.00 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $5.13 | $5.62 | $6.61 |
Where Iowa sits
The same service costs 3.0 times more in Alaska than in Connecticut. 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· 10th of 51
$83.18
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.