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 $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $25.12 | Professional | None | $16.22 | $16.22 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $30.90 | Facility | None | $28.84 | $28.84 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $42.66 Typical High $46.77 | Professional | None | $14.79 | $42.66 | $46.77 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $44.67 | Professional | None | $40.74 | $41.69 | $44.67 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $41.69 Typical High $151.36 | Facility | None | $17.38 | $41.69 | $151.36 |
Medica Setting Professional Modifier None Typical Low $16.60 Median $28.84 Typical High $199.53 | Professional | None | $16.60 | $28.84 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $14.79 Median $42.66 Typical High $57.54 | Professional | None | $14.79 | $42.66 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | None | $54.95 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $16.22 Median $17.38 Typical High $33.88 | Professional | None | $16.22 | $17.38 | $33.88 |
Wellmark Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
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 $7.94 Median $7.94 Typical High $12.59 | Professional | 52 · Reduced service | $7.94 | $7.94 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $5.01 | Professional | 53 · Discontinued | $3.24 | $3.24 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $3.80 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $2.51 |
Where Iowa sits
The same service costs 4.1 times more in Wyoming than in Utah. 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· 16th of 51
$25.70
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.