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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $85.11 | Professional | None | $43.65 | $63.10 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $112.20 | Facility | None | $81.28 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $165.96 | Professional | None | $107.15 | $141.25 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $194.98 | Professional | None | $85.11 | $114.82 | $194.98 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $109.65 Typical High $489.78 | Facility | None | $67.61 | $109.65 | $489.78 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $275.42 | Professional | None | $48.98 | $85.11 | $275.42 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | None | $117.49 | $141.25 | $141.25 |
Midlands Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $165.96 | Professional | None | $107.15 | $165.96 | $165.96 |
United Setting Facility Modifier None Typical Low $93.33 Median $154.88 Typical High $295.12 | Facility | None | $93.33 | $154.88 | $295.12 |
United Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $87.10 | Professional | None | $46.77 | $48.98 | $87.10 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $21.88 Median $31.62 Typical High $42.66 | Professional | 52 · Reduced service | $21.88 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.59 Typical High $16.98 | Professional | 53 · Discontinued | $8.71 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.55 Typical High $12.88 | Professional | 55 · Aftercare only | $6.61 | $9.55 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.31 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.37 | $6.31 | $8.51 |
Where Iowa sits
The same service costs 4.4 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· 6th of 51
$100
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.