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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $44.67 | Professional | None | $28.84 | $28.84 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Facility | None | $50.12 | $50.12 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $83.18 | Professional | None | $57.54 | $75.86 | $83.18 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $97.72 | Professional | None | $89.13 | $91.20 | $97.72 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $74.13 Typical High $269.15 | Facility | None | $52.48 | $74.13 | $269.15 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $57.54 Typical High $354.81 | Professional | None | $29.51 | $57.54 | $354.81 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $104.71 | Professional | None | $58.88 | $75.86 | $104.71 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $29.51 Median $30.90 Typical High $60.26 | Professional | None | $29.51 | $30.90 | $60.26 |
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 $14.45 Median $14.45 Typical High $22.39 | Professional | 52 · Reduced service | $14.45 | $14.45 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $9.12 | Professional | 53 · Discontinued | $5.75 | $5.75 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $6.76 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $4.47 |
Where Iowa sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 7th of 51
$51.29
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.