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 $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $158.49 | Professional | None | $79.43 | $109.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $194.98 Typical High $194.98 | Facility | None | $117.49 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $251.19 | Professional | None | $177.83 | $229.09 | $251.19 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $199.53 | Professional | None | $144.54 | $173.78 | $199.53 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $812.83 | Facility | None | $117.49 | $190.55 | $812.83 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $446.68 | Professional | None | $83.18 | $147.91 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | None | $199.53 | $229.09 | $229.09 |
Midlands Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $288.40 | Professional | None | $177.83 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $489.78 | Facility | None | $208.93 | $251.19 | $489.78 |
United Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $151.36 | Professional | None | $77.62 | $85.11 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
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 $40.74 Median $54.95 Typical High $79.43 | Professional | 52 · Reduced service | $40.74 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $16.22 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $16.60 Typical High $23.44 | Professional | 55 · Aftercare only | $12.02 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $8.13 | $10.96 | $15.85 |
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· 5th of 51
$170
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.