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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $25.70 Typical High $31.62 | Professional | None | $16.22 | $25.70 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $44.67 Typical High $44.67 | Facility | None | $22.39 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $52.48 | Professional | None | $37.15 | $44.67 | $52.48 |
Hally Health Setting Professional Modifier None Typical Low $26.92 Median $38.02 Typical High $46.77 | Professional | None | $26.92 | $38.02 | $46.77 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $43.65 Typical High $162.18 | Facility | None | $27.54 | $43.65 | $162.18 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $33.88 Typical High $87.10 | Professional | None | $17.78 | $33.88 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $46.77 | Professional | None | $44.67 | $44.67 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $66.07 Typical High $66.07 | Professional | None | $34.67 | $66.07 | $66.07 |
United Setting Facility Modifier None Typical Low $28.18 Median $48.98 Typical High $93.33 | Facility | None | $28.18 | $48.98 | $93.33 |
United Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $35.48 | Professional | None | $14.79 | $19.95 | $35.48 |
Wellmark Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $7.76 Median $12.88 Typical High $15.85 | Professional | 52 · Reduced service | $7.76 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $5.13 Typical High $6.31 | Professional | 53 · Discontinued | $3.09 | $5.13 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.80 Typical High $4.79 | Professional | 55 · Aftercare only | $2.34 | $3.80 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.51 Typical High $3.16 | Professional | 56 · Pre-op care only | $1.55 | $2.51 | $3.16 |
Where Iowa sits
The same service costs 3.7 times more in Hawaii than in Florida. 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· 3rd of 51
$39.81
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.