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 $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $29.51 Typical High $41.69 | Professional | None | $21.38 | $29.51 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $26.92 Median $51.29 Typical High $51.29 | Facility | None | $26.92 | $51.29 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $66.07 | Professional | None | $46.77 | $61.66 | $66.07 |
Hally Health Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $53.70 | Professional | None | $37.15 | $45.71 | $53.70 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $213.80 | Facility | None | $44.67 | $58.88 | $213.80 |
Medica Setting Professional Modifier None Typical Low $22.39 Median $38.90 Typical High $120.23 | Professional | None | $22.39 | $38.90 | $120.23 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $61.66 | Professional | None | $53.70 | $61.66 | $61.66 |
Midlands Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $75.86 | Professional | None | $46.77 | $75.86 | $75.86 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $128.82 | Facility | None | $67.61 | $67.61 | $128.82 |
United Setting Professional Modifier None Typical Low $20.42 Median $22.91 Typical High $40.74 | Professional | None | $20.42 | $22.91 | $40.74 |
Wellmark Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $10.72 Median $14.79 Typical High $20.89 | Professional | 52 · Reduced service | $10.72 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $5.89 Typical High $8.32 | Professional | 53 · Discontinued | $4.27 | $5.89 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $4.37 Typical High $6.31 | Professional | 55 · Aftercare only | $3.24 | $4.37 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.95 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.14 | $2.95 | $4.17 |
Where Iowa sits
The same service costs 2.5 times more in Montana 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
$45.71
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.