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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $190.55 | Professional | None | $95.50 | $131.83 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $234.42 Typical High $234.42 | Facility | None | $147.91 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $302.00 | Professional | None | $213.80 | $281.84 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $251.19 | Professional | None | $165.96 | $208.93 | $251.19 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $229.09 Typical High $977.24 | Facility | None | $141.25 | $229.09 | $977.24 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $549.54 | Professional | None | $102.33 | $177.83 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | None | $245.47 | $281.84 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $346.74 | Professional | None | $213.80 | $346.74 | $346.74 |
United Setting Facility Modifier None Typical Low $257.04 Median $309.03 Typical High $588.84 | Facility | None | $257.04 | $309.03 | $588.84 |
United Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $181.97 | Professional | None | $93.33 | $104.71 | $181.97 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
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 $48.98 Median $66.07 Typical High $95.50 | Professional | 52 · Reduced service | $48.98 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.30 Typical High $38.02 | Professional | 53 · Discontinued | $19.50 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.95 Typical High $28.84 | Professional | 55 · Aftercare only | $14.45 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $13.18 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.77 | $13.18 | $19.05 |
Where Iowa sits
The same service costs 5.4 times more in Kansas than in West Virginia. 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· 4th of 51
$209
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.