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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $169.82 | Professional | None | $72.44 | $89.13 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $154.88 Typical High $154.88 | Facility | None | $91.20 | $154.88 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $208.93 | Professional | None | $144.54 | $204.17 | $208.93 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $162.18 | Professional | None | $112.20 | $131.83 | $162.18 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $154.88 Typical High $707.95 | Facility | None | $95.50 | $154.88 | $707.95 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $123.03 Typical High $407.38 | Professional | None | $69.18 | $123.03 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $208.93 | Professional | None | $162.18 | $208.93 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $234.42 | Professional | None | $158.49 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $69.18 Median $229.09 Typical High $436.52 | Facility | None | $69.18 | $229.09 | $436.52 |
United Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $123.03 | Professional | None | $67.61 | $69.18 | $123.03 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
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 $37.15 Median $44.67 Typical High $85.11 | Professional | 52 · Reduced service | $37.15 | $44.67 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.78 Typical High $33.88 | Professional | 53 · Discontinued | $15.14 | $17.78 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.49 Typical High $25.12 | Professional | 55 · Aftercare only | $11.22 | $13.49 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.59 | $8.91 | $16.98 |
Where Iowa sits
The same service costs 2.5 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· 8th of 51
$138
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.