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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $60.26 | Professional | None | $30.20 | $41.69 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $74.13 Typical High $74.13 | Facility | None | $37.15 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $95.50 | Professional | None | $67.61 | $87.10 | $95.50 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $66.07 Typical High $77.62 | Professional | None | $52.48 | $66.07 | $77.62 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $85.11 Typical High $309.03 | Facility | None | $64.57 | $85.11 | $309.03 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $56.23 Typical High $169.82 | Professional | None | $32.36 | $56.23 | $169.82 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | None | $75.86 | $87.10 | $87.10 |
Midlands Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $109.65 | Professional | None | $67.61 | $109.65 | $109.65 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $186.21 | Facility | None | $95.50 | $95.50 | $186.21 |
United Setting Professional Modifier None Typical Low $29.51 Median $32.36 Typical High $57.54 | Professional | None | $29.51 | $32.36 | $57.54 |
Wellmark Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
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 $15.49 Median $20.89 Typical High $30.20 | Professional | 52 · Reduced service | $15.49 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.32 Typical High $12.02 | Professional | 53 · Discontinued | $6.17 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $6.31 Typical High $9.12 | Professional | 55 · Aftercare only | $4.57 | $6.31 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.17 Typical High $6.03 | Professional | 56 · Pre-op care only | $3.09 | $4.17 | $6.03 |
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· 5th of 51
$64.57
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.