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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $38.90 Typical High $57.54 | Professional | None | $28.18 | $38.90 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $69.18 Typical High $69.18 | Facility | None | $33.88 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $89.13 | Professional | None | $63.10 | $81.28 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $70.79 | Professional | None | $48.98 | $61.66 | $70.79 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $67.61 Typical High $288.40 | Facility | None | $41.69 | $67.61 | $288.40 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $52.48 Typical High $158.49 | Professional | None | $29.51 | $52.48 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $81.28 | Professional | None | $70.79 | $81.28 | $81.28 |
Midlands Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $102.33 | Professional | None | $63.10 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $173.78 | Facility | None | $89.13 | $89.13 | $173.78 |
United Setting Professional Modifier None Typical Low $27.54 Median $30.20 Typical High $53.70 | Professional | None | $27.54 | $30.20 | $53.70 |
Wellmark Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $14.45 Median $19.50 Typical High $28.18 | Professional | 52 · Reduced service | $14.45 | $19.50 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.76 Typical High $11.22 | Professional | 53 · Discontinued | $5.75 | $7.76 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.89 Typical High $8.32 | Professional | 55 · Aftercare only | $4.27 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.89 Typical High $5.62 | Professional | 56 · Pre-op care only | $2.88 | $3.89 | $5.62 |
Where Iowa sits
The same service costs 2.8 times more in Montana 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· 4th of 51
$58.88
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.