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 $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $51.29 Typical High $60.26 | Professional | None | $30.90 | $51.29 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $91.20 | Facility | None | $56.23 | $91.20 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $117.49 | Professional | None | $83.18 | $100.00 | $117.49 |
Hally Health Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $95.50 | Professional | None | $64.57 | $81.28 | $95.50 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $363.08 | Facility | None | $54.95 | $89.13 | $363.08 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $190.55 | Professional | None | $38.90 | $69.18 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $100.00 Typical High $107.15 | Professional | None | $95.50 | $100.00 | $107.15 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $134.90 | Professional | None | $75.86 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $89.13 Median $107.15 Typical High $208.93 | Facility | None | $89.13 | $107.15 | $208.93 |
United Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $70.79 | Professional | None | $33.11 | $40.74 | $70.79 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $15.85 Median $25.70 Typical High $30.20 | Professional | 52 · Reduced service | $15.85 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $10.47 Typical High $12.02 | Professional | 53 · Discontinued | $6.31 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.76 Typical High $9.12 | Professional | 55 · Aftercare only | $4.68 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.13 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.16 | $5.13 | $6.03 |
Where Iowa sits
The same service costs 3.1 times more in Hawaii than in Kentucky. 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· 5th of 51
$77.62
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.