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 $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $162.18 | Professional | None | $83.18 | $125.89 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $223.87 Typical High $223.87 | Facility | None | $109.65 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $263.03 | Professional | None | $204.17 | $263.03 | $263.03 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $229.09 | Professional | None | $151.36 | $194.98 | $229.09 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $218.78 Typical High $912.01 | Facility | None | $134.90 | $218.78 | $912.01 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $169.82 Typical High $512.86 | Professional | None | $97.72 | $169.82 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $263.03 | Professional | None | $229.09 | $263.03 | $263.03 |
Midlands Setting Facility Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $331.13 | Professional | None | $204.17 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $107.15 Median $288.40 Typical High $549.54 | Facility | None | $107.15 | $288.40 | $549.54 |
United Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $173.78 | Professional | None | $87.10 | $97.72 | $173.78 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
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 $41.69 Median $63.10 Typical High $79.43 | Professional | 52 · Reduced service | $41.69 | $63.10 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $25.12 Typical High $32.36 | Professional | 53 · Discontinued | $16.60 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $19.05 Typical High $23.99 | Professional | 55 · Aftercare only | $12.59 | $19.05 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $12.59 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.32 | $12.59 | $16.22 |
Where Iowa sits
The same service costs 3.0 times more in Montana 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· 8th of 51
$200
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.