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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $38.90 Typical High $54.95 | Professional | None | $28.18 | $38.90 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $67.61 Typical High $67.61 | Facility | None | $48.98 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $102.33 | Professional | None | $66.07 | $91.20 | $102.33 |
Hally Health Setting Professional Modifier None Typical Low $51.29 Median $66.07 Typical High $74.13 | Professional | None | $51.29 | $66.07 | $74.13 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $66.07 Typical High $331.13 | Facility | None | $41.69 | $66.07 | $331.13 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $56.23 Typical High $173.78 | Professional | None | $30.20 | $56.23 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | None | $70.79 | $91.20 | $91.20 |
Midlands Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $102.33 Typical High $102.33 | Professional | None | $69.18 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $52.48 Median $97.72 Typical High $190.55 | Facility | None | $52.48 | $97.72 | $190.55 |
United Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $53.70 | Professional | None | $28.84 | $30.20 | $53.70 |
Wellmark Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $14.13 Median $19.50 Typical High $28.18 | Professional | 52 · Reduced service | $14.13 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $7.76 Typical High $11.48 | Professional | 53 · Discontinued | $5.62 | $7.76 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $5.75 Typical High $8.51 | Professional | 55 · Aftercare only | $4.17 | $5.75 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.89 Typical High $5.75 | Professional | 56 · Pre-op care only | $2.82 | $3.89 | $5.75 |
Where Iowa sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 12th of 51
$60.26
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.