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 $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $33.11 Typical High $47.86 | Professional | None | $24.55 | $33.11 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $57.54 Typical High $57.54 | Facility | None | $34.67 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $75.86 | Professional | None | $53.70 | $69.18 | $75.86 |
Hally Health Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $66.07 | Professional | None | $41.69 | $52.48 | $66.07 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $57.54 Typical High $239.88 | Facility | None | $35.48 | $57.54 | $239.88 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $134.90 | Professional | None | $25.12 | $44.67 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | None | $60.26 | $69.18 | $69.18 |
Midlands Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $87.10 Typical High $87.10 | Professional | None | $53.70 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $144.54 | Facility | None | $75.86 | $75.86 | $144.54 |
United Setting Professional Modifier None Typical Low $23.44 Median $25.70 Typical High $45.71 | Professional | None | $23.44 | $25.70 | $45.71 |
Wellmark Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $12.02 Median $16.60 Typical High $23.99 | Professional | 52 · Reduced service | $12.02 | $16.60 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.61 Typical High $9.55 | Professional | 53 · Discontinued | $4.90 | $6.61 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $5.01 Typical High $7.08 | Professional | 55 · Aftercare only | $3.63 | $5.01 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.31 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.45 | $3.31 | $4.79 |
Where Iowa sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 6th of 51
$50.12
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.