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 $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $83.18 | Professional | None | $41.69 | $56.23 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $100.00 | Facility | None | $56.23 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $128.82 | Professional | None | $91.20 | $117.49 | $128.82 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $102.33 | Professional | None | $75.86 | $89.13 | $102.33 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $97.72 Typical High $416.87 | Facility | None | $60.26 | $97.72 | $416.87 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $75.86 Typical High $229.09 | Professional | None | $43.65 | $75.86 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | None | $102.33 | $117.49 | $117.49 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $147.91 | Professional | None | $91.20 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $251.19 | Facility | None | $128.82 | $128.82 | $251.19 |
United Setting Professional Modifier None Typical Low $39.81 Median $43.65 Typical High $77.62 | Professional | None | $39.81 | $43.65 | $77.62 |
Wellmark Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $20.89 Median $28.18 Typical High $40.74 | Professional | 52 · Reduced service | $20.89 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.22 Typical High $16.22 | Professional | 53 · Discontinued | $8.32 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.51 Typical High $12.30 | Professional | 55 · Aftercare only | $6.17 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.62 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.17 | $5.62 | $8.13 |
Where Iowa sits
The same service costs 3.1 times more in Hawaii than in Kansas. 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
$85.11
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.