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 $61.66 Median $120.23 Typical High $120.23 | Facility | None | $61.66 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $79.43 | Professional | None | $37.15 | $61.66 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $107.15 Typical High $107.15 | Facility | None | $46.77 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $128.82 | Professional | None | $83.18 | $107.15 | $128.82 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $112.20 | Professional | None | $69.18 | $95.50 | $112.20 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $380.19 | Facility | None | $66.07 | $104.71 | $380.19 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $83.18 Typical High $208.93 | Professional | None | $42.66 | $83.18 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | None | $107.15 | $107.15 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $162.18 | Professional | None | $83.18 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $36.31 Median $117.49 Typical High $229.09 | Facility | None | $36.31 | $117.49 | $229.09 |
United Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $85.11 | Professional | None | $36.31 | $47.86 | $85.11 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $18.62 Median $30.90 Typical High $39.81 | Professional | 52 · Reduced service | $18.62 | $30.90 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $12.30 Typical High $15.85 | Professional | 53 · Discontinued | $7.41 | $12.30 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $9.33 Typical High $12.02 | Professional | 55 · Aftercare only | $5.62 | $9.33 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.17 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.72 | $6.17 | $7.94 |
Where Iowa sits
The same service costs 2.9 times more in Kansas 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· 2nd of 51
$95.50
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.