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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $27.54 | Professional | None | $19.50 | $19.50 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Facility | None | $30.20 | $30.20 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $83.18 | Professional | None | $44.67 | $52.48 | $83.18 |
Hally Health Setting Professional Modifier None Typical Low $57.54 Median $58.88 Typical High $64.57 | Professional | None | $57.54 | $58.88 | $64.57 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $50.12 Typical High $186.21 | Facility | None | $35.48 | $50.12 | $186.21 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $44.67 Typical High $245.47 | Professional | None | $20.42 | $44.67 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | None | $67.61 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $19.95 Median $21.38 Typical High $41.69 | Professional | None | $19.95 | $21.38 | $41.69 |
Wellmark Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $9.77 Median $9.77 Typical High $15.49 | Professional | 52 · Reduced service | $9.77 | $9.77 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $6.17 | Professional | 53 · Discontinued | $3.89 | $3.89 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $4.68 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $3.09 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $3.09 |
Where Iowa sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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· 10th of 51
$45.71
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.