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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $38.02 Typical High $54.95 | Professional | None | $27.54 | $38.02 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $66.07 Typical High $66.07 | Facility | None | $33.11 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $87.10 | Professional | None | $61.66 | $79.43 | $87.10 |
Hally Health Setting Professional Modifier None Typical Low $47.86 Median $60.26 Typical High $69.18 | Professional | None | $47.86 | $60.26 | $69.18 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $75.86 Typical High $275.42 | Facility | None | $57.54 | $75.86 | $275.42 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $51.29 Typical High $154.88 | Professional | None | $28.84 | $51.29 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | None | $69.18 | $79.43 | $79.43 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $100.00 | Professional | None | $61.66 | $100.00 | $100.00 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $165.96 | Facility | None | $87.10 | $87.10 | $165.96 |
United Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $52.48 | Professional | None | $26.92 | $29.51 | $52.48 |
Wellmark Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
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 $13.80 Median $19.05 Typical High $27.54 | Professional | 52 · Reduced service | $13.80 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $7.59 Typical High $10.96 | Professional | 53 · Discontinued | $5.62 | $7.59 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $5.75 Typical High $8.13 | Professional | 55 · Aftercare only | $4.17 | $5.75 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.80 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.82 | $3.80 | $5.50 |
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
$57.54
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.