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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $95.50 | Professional | None | $47.86 | $67.61 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $117.49 | Facility | None | $67.61 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $151.36 | Professional | None | $107.15 | $141.25 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $123.03 | Professional | None | $83.18 | $104.71 | $123.03 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $489.78 | Facility | None | $70.79 | $114.82 | $489.78 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $269.15 | Professional | None | $51.29 | $89.13 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | None | $123.03 | $141.25 | $141.25 |
Midlands Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $173.78 Typical High $173.78 | Professional | None | $107.15 | $173.78 | $173.78 |
United Setting Facility Modifier None Typical Low $60.26 Median $154.88 Typical High $295.12 | Facility | None | $60.26 | $154.88 | $295.12 |
United Setting Professional Modifier None Typical Low $46.77 Median $52.48 Typical High $91.20 | Professional | None | $46.77 | $52.48 | $91.20 |
Wellmark Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
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 $24.55 Median $33.11 Typical High $47.86 | Professional | 52 · Reduced service | $24.55 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $13.49 Typical High $19.05 | Professional | 53 · Discontinued | $9.77 | $13.49 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.00 Typical High $14.45 | Professional | 55 · Aftercare only | $7.41 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.90 | $6.76 | $9.55 |
Where Iowa sits
The same service costs 2.1 times more in Montana 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· 2nd of 51
$105
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.