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 $6.92 Median $13.80 Typical High $13.80 | Facility | None | $6.92 | $13.80 | $13.80 |
Aetna Setting Professional Modifier None Typical Low $6.92 Median $7.41 Typical High $13.80 | Professional | None | $6.92 | $7.41 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $21.38 | Facility | None | $12.30 | $12.30 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $18.62 Typical High $22.39 | Professional | None | $14.79 | $18.62 | $22.39 |
Hally Health Setting Professional Modifier None Typical Low $25.12 Median $30.20 Typical High $43.65 | Professional | None | $25.12 | $30.20 | $43.65 |
Medica Setting Facility Modifier None Typical Low $12.02 Median $15.49 Typical High $89.13 | Facility | None | $12.02 | $15.49 | $89.13 |
Medica Setting Professional Modifier None Typical Low $7.24 Median $16.60 Typical High $87.10 | Professional | None | $7.24 | $16.60 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | None | $18.62 | $18.62 | $25.70 |
Midlands Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Midlands Setting Professional Modifier None Typical Low $23.99 Median $25.12 Typical High $25.12 | Professional | None | $23.99 | $25.12 | $25.12 |
United Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $14.79 | Professional | None | $7.08 | $7.59 | $14.79 |
Wellmark Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
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 $3.47 Median $3.47 Typical High $5.50 | Professional | 52 · Reduced service | $3.47 | $3.47 | $5.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $2.19 | Professional | 53 · Discontinued | $1.41 | $1.41 | $2.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.05 Median $1.05 Typical High $1.66 | Professional | 55 · Aftercare only | $1.05 | $1.05 | $1.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $1.10 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $1.10 |
Where Iowa sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 9th of 51
$17.38
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.