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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $37.15 Typical High $63.10 | Professional | None | $32.36 | $37.15 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $85.11 Typical High $85.11 | Facility | None | $52.48 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $102.33 | Professional | None | $67.61 | $85.11 | $102.33 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $95.50 | Professional | None | $50.12 | $57.54 | $95.50 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $83.18 Typical High $257.04 | Facility | None | $66.07 | $83.18 | $257.04 |
Medica Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $194.98 | Professional | None | $45.71 | $79.43 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | None | $85.11 | $85.11 | $93.33 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $218.78 | Facility | None | $112.20 | $112.20 | $218.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $83.18 | Professional | None | $41.69 | $46.77 | $83.18 |
Wellmark Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $16.22 Median $18.62 Typical High $27.54 | Professional | 52 · Reduced service | $16.22 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.41 Typical High $10.96 | Professional | 53 · Discontinued | $6.46 | $7.41 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.50 Typical High $8.32 | Professional | 55 · Aftercare only | $4.90 | $5.50 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.72 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.24 | $3.72 | $5.50 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 4th of 51
$75.86
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.