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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $66.07 Typical High $89.13 | Professional | None | $44.67 | $66.07 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $117.49 Typical High $117.49 | Facility | None | $58.88 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $141.25 | Professional | None | $107.15 | $138.04 | $141.25 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $120.23 | Professional | None | $83.18 | $102.33 | $120.23 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $114.82 Typical High $478.63 | Facility | None | $70.79 | $114.82 | $478.63 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $89.13 Typical High $275.42 | Professional | None | $51.29 | $89.13 | $275.42 |
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 $46.77 Median $154.88 Typical High $295.12 | Facility | None | $46.77 | $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 $22.39 Median $33.11 Typical High $44.67 | Professional | 52 · Reduced service | $22.39 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $13.18 Typical High $17.78 | Professional | 53 · Discontinued | $8.91 | $13.18 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.00 Typical High $13.18 | Professional | 55 · Aftercare only | $6.76 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.61 Typical High $8.91 | Professional | 56 · Pre-op care only | $4.47 | $6.61 | $8.91 |
Where Iowa sits
The same service costs 2.5 times more in Arkansas 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· 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.