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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $66.07 Typical High $93.33 | Professional | None | $47.86 | $66.07 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $114.82 Typical High $114.82 | Facility | None | $57.54 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $138.04 Typical High $147.91 | Professional | None | $104.71 | $138.04 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $125.89 | Professional | None | $81.28 | $102.33 | $125.89 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $478.63 | Facility | None | $100.00 | $131.83 | $478.63 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $263.03 | Professional | None | $50.12 | $87.10 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | None | $120.23 | $138.04 | $138.04 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $169.82 Typical High $169.82 | Professional | None | $104.71 | $169.82 | $169.82 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $288.40 | Facility | None | $151.36 | $151.36 | $288.40 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $89.13 | Professional | None | $45.71 | $51.29 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $23.99 Median $32.36 Typical High $46.77 | Professional | 52 · Reduced service | $23.99 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $13.18 Typical High $18.62 | Professional | 53 · Discontinued | $9.55 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $14.13 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.61 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.79 | $6.61 | $9.33 |
Where Iowa sits
The same service costs 2.6 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· 7th of 51
$100
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.