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 $12.59 Median $12.59 Typical High $12.59 | Facility | None | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier None Typical Low $9.33 Median $12.59 Typical High $18.20 | Professional | None | $9.33 | $12.59 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $21.88 Typical High $21.88 | Facility | None | $13.49 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $29.51 Typical High $30.20 | Professional | None | $20.42 | $29.51 | $30.20 |
Hally Health Setting Professional Modifier None Typical Low $16.60 Median $20.42 Typical High $25.70 | Professional | None | $16.60 | $20.42 | $25.70 |
Medica Setting Facility Modifier None Typical Low $13.49 Median $21.88 Typical High $102.33 | Facility | None | $13.49 | $21.88 | $102.33 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $16.98 Typical High $57.54 | Professional | None | $9.77 | $16.98 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | None | $22.91 | $29.51 | $29.51 |
Midlands Setting Facility Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Midlands Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $33.11 | Professional | None | $22.39 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $9.77 Median $32.36 Typical High $61.66 | Facility | None | $9.77 | $32.36 | $61.66 |
United Setting Professional Modifier None Typical Low $9.55 Median $9.77 Typical High $17.38 | Professional | None | $9.55 | $9.77 | $17.38 |
Wellmark Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
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 $4.68 Median $6.31 Typical High $9.12 | Professional | 52 · Reduced service | $4.68 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.86 Median $2.51 Typical High $3.63 | Professional | 53 · Discontinued | $1.86 | $2.51 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.41 Median $1.91 Typical High $2.75 | Professional | 55 · Aftercare only | $1.41 | $1.91 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.93 Median $1.26 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.93 | $1.26 | $1.82 |
Where Iowa sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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
$19.50
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.