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 $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $72.44 | Professional | None | $32.36 | $39.81 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $69.18 Typical High $69.18 | Facility | None | $40.74 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $93.33 | Professional | None | $67.61 | $91.20 | $93.33 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $79.43 | Professional | None | $52.48 | $63.10 | $79.43 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $69.18 Typical High $323.59 | Facility | None | $42.66 | $69.18 | $323.59 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $60.26 Typical High $181.97 | Professional | None | $30.90 | $60.26 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | None | $72.44 | $93.33 | $93.33 |
Midlands Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $104.71 | Professional | None | $70.79 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $40.74 Median $102.33 Typical High $194.98 | Facility | None | $40.74 | $102.33 | $194.98 |
United Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $54.95 | Professional | None | $30.20 | $30.90 | $54.95 |
Wellmark Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $19.95 Typical High $36.31 | Professional | 52 · Reduced service | $16.22 | $19.95 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.94 Typical High $14.45 | Professional | 53 · Discontinued | $6.46 | $7.94 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $6.03 Typical High $10.96 | Professional | 55 · Aftercare only | $4.90 | $6.03 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.98 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.24 | $3.98 | $7.24 |
Where Iowa sits
The same service costs 2.7 times more in Montana 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· 12th of 51
$61.66
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.