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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | None | $67.61 | $67.61 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Facility | None | $56.23 | $56.23 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $281.84 | Professional | None | $138.04 | $181.97 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $371.54 | Professional | None | $338.84 | $354.81 | $371.54 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $645.65 | Facility | None | $123.03 | $173.78 | $645.65 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $162.18 Typical High $851.14 | Professional | None | $70.79 | $162.18 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $281.84 | Professional | None | $181.97 | $181.97 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | None | $229.09 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $144.54 | Professional | None | $69.18 | $74.13 | $144.54 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $33.88 Median $33.88 Typical High $53.70 | Professional | 52 · Reduced service | $33.88 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $21.38 | Professional | 53 · Discontinued | $13.80 | $13.80 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $16.22 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $10.72 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $10.72 |
Where Iowa sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 2nd of 51
$174
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.