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 $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $117.49 Typical High $223.87 | Professional | None | $95.50 | $117.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $204.17 | Facility | None | $125.89 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $275.42 | Professional | None | $190.55 | $269.15 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $234.42 | Professional | None | $151.36 | $181.97 | $234.42 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $204.17 Typical High $1,000.00 | Facility | None | $125.89 | $204.17 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $537.03 | Professional | None | $91.20 | $162.18 | $537.03 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $275.42 | Professional | None | $213.80 | $275.42 | $275.42 |
Midlands Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $309.03 | Professional | None | $208.93 | $309.03 | $309.03 |
United Setting Facility Modifier None Typical Low $100.00 Median $302.00 Typical High $575.44 | Facility | None | $100.00 | $302.00 | $575.44 |
United Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $162.18 | Professional | None | $89.13 | $91.20 | $162.18 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $47.86 Median $58.88 Typical High $112.20 | Professional | 52 · Reduced service | $47.86 | $58.88 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.44 Typical High $44.67 | Professional | 53 · Discontinued | $19.05 | $23.44 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $33.11 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $22.39 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $22.39 |
Where Iowa sits
The same service costs 2.4 times more in Hawaii than in Delaware. 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
$182
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.