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 $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $81.28 | Professional | None | $38.90 | $48.98 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $85.11 Typical High $85.11 | Facility | None | $48.98 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $112.20 | Professional | None | $77.62 | $109.65 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $120.23 | Professional | None | $60.26 | $89.13 | $120.23 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $398.11 | Facility | None | $51.29 | $83.18 | $398.11 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $218.78 | Professional | None | $38.02 | $67.61 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $112.20 | Professional | None | $89.13 | $112.20 | $112.20 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $125.89 | Professional | None | $87.10 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $64.57 Median $123.03 Typical High $239.88 | Facility | None | $64.57 | $123.03 | $239.88 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $67.61 | Professional | None | $36.31 | $38.02 | $67.61 |
Wellmark Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $19.50 Median $23.99 Typical High $39.81 | Professional | 52 · Reduced service | $19.50 | $23.99 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.77 Typical High $15.85 | Professional | 53 · Discontinued | $7.76 | $9.77 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.24 Typical High $11.75 | Professional | 55 · Aftercare only | $5.89 | $7.24 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.79 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.89 | $4.79 | $7.94 |
Where Iowa sits
The same service costs 4.7 times more in Hawaii 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· 7th of 51
$75.86
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.