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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $56.23 Typical High $102.33 | Professional | None | $50.12 | $56.23 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $97.72 | Facility | None | $64.57 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $144.54 | Professional | None | $95.50 | $131.83 | $144.54 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $123.03 | Professional | None | $79.43 | $100.00 | $123.03 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $467.74 | Facility | None | $60.26 | $95.50 | $467.74 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $81.28 Typical High $251.19 | Professional | None | $43.65 | $81.28 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | None | $102.33 | $131.83 | $131.83 |
Midlands Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $144.54 | Professional | None | $100.00 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $60.26 Median $141.25 Typical High $275.42 | Facility | None | $60.26 | $141.25 | $275.42 |
United Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $77.62 | Professional | None | $42.66 | $43.65 | $77.62 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $25.70 Median $28.18 Typical High $50.12 | Professional | 52 · Reduced service | $25.70 | $28.18 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.22 Typical High $20.42 | Professional | 53 · Discontinued | $10.23 | $11.22 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.32 Typical High $15.14 | Professional | 55 · Aftercare only | $7.59 | $8.32 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.62 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.13 | $5.62 | $10.23 |
Where Iowa sits
The same service costs 3.5 times more in Hawaii than in New Jersey. 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
$87.10
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.