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 $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $91.20 | Professional | None | $46.77 | $61.66 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $109.65 Typical High $109.65 | Facility | None | $72.44 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $151.36 | Professional | None | $100.00 | $144.54 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $104.71 Typical High $125.89 | Professional | None | $85.11 | $104.71 | $125.89 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $107.15 Typical High $512.86 | Facility | None | $66.07 | $107.15 | $512.86 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $87.10 Typical High $281.84 | Professional | None | $48.98 | $87.10 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | None | $114.82 | $144.54 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $162.18 | Professional | None | $112.20 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $64.57 Median $158.49 Typical High $302.00 | Facility | None | $64.57 | $158.49 | $302.00 |
United Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $87.10 | Professional | None | $47.86 | $48.98 | $87.10 |
Wellmark Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $23.44 Median $30.90 Typical High $44.67 | Professional | 52 · Reduced service | $23.44 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.30 Typical High $18.20 | Professional | 53 · Discontinued | $9.33 | $12.30 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.33 Typical High $13.49 | Professional | 55 · Aftercare only | $7.08 | $9.33 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.17 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.68 | $6.17 | $9.12 |
Where Iowa sits
The same service costs 3.2 times more in Hawaii than in Florida. 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· 7th of 51
$97.72
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.