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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $50.12 Typical High $64.57 | Professional | None | $31.62 | $50.12 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $87.10 Typical High $87.10 | Facility | None | $36.31 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $117.49 | Professional | None | $81.28 | $100.00 | $117.49 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $91.20 | Professional | None | $63.10 | $77.62 | $91.20 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $87.10 Typical High $354.81 | Facility | None | $53.70 | $87.10 | $354.81 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $194.98 | Professional | None | $38.02 | $67.61 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $104.71 | Professional | None | $91.20 | $100.00 | $104.71 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $131.83 Typical High $131.83 | Professional | None | $77.62 | $131.83 | $131.83 |
United Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $213.80 | Facility | None | $91.20 | $109.65 | $213.80 |
United Setting Professional Modifier None Typical Low $33.88 Median $38.90 Typical High $69.18 | Professional | None | $33.88 | $38.90 | $69.18 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $25.12 Typical High $32.36 | Professional | 52 · Reduced service | $16.22 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $10.00 Typical High $12.88 | Professional | 53 · Discontinued | $6.46 | $10.00 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $7.59 Typical High $9.55 | Professional | 55 · Aftercare only | $4.79 | $7.59 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $5.01 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.24 | $5.01 | $6.46 |
Where Iowa sits
The same service costs 2.9 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· 5th of 51
$77.62
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.