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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $144.54 | Professional | None | $72.44 | $100.00 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $173.78 Typical High $173.78 | Facility | None | $89.13 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $229.09 | Professional | None | $162.18 | $208.93 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $181.97 | Professional | None | $131.83 | $154.88 | $181.97 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $173.78 Typical High $741.31 | Facility | None | $107.15 | $173.78 | $741.31 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $407.38 | Professional | None | $75.86 | $134.90 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $208.93 | Professional | None | $181.97 | $208.93 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $263.03 | Professional | None | $162.18 | $263.03 | $263.03 |
United Setting Facility Modifier None Typical Low $190.55 Median $229.09 Typical High $446.68 | Facility | None | $190.55 | $229.09 | $446.68 |
United Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $138.04 | Professional | None | $70.79 | $77.62 | $138.04 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $37.15 Median $50.12 Typical High $72.44 | Professional | 52 · Reduced service | $37.15 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $19.95 Typical High $28.84 | Professional | 53 · Discontinued | $14.79 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $10.96 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.00 Typical High $14.45 | Professional | 56 · Pre-op care only | $7.41 | $10.00 | $14.45 |
Where Iowa sits
The same service costs 2.8 times more in Kansas 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· 4th of 51
$155
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.