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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $52.48 Typical High $97.72 | Professional | None | $48.98 | $52.48 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $91.20 Typical High $91.20 | Facility | None | $61.66 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $134.90 | Professional | None | $89.13 | $123.03 | $134.90 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $109.65 | Professional | None | $75.86 | $95.50 | $109.65 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $89.13 Typical High $436.52 | Facility | None | $56.23 | $89.13 | $436.52 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $234.42 | Professional | None | $40.74 | $79.43 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | None | $95.50 | $123.03 | $123.03 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $134.90 Typical High $134.90 | Professional | None | $93.33 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $45.71 Median $131.83 Typical High $257.04 | Facility | None | $45.71 | $131.83 | $257.04 |
United Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $72.44 | Professional | None | $39.81 | $40.74 | $72.44 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $24.55 Median $26.30 Typical High $48.98 | Professional | 52 · Reduced service | $24.55 | $26.30 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $19.95 | Professional | 53 · Discontinued | $9.77 | $10.47 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.76 Typical High $14.79 | Professional | 55 · Aftercare only | $7.24 | $7.76 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $9.77 |
Where Iowa sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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· 8th of 51
$81.28
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.