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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | None | $89.13 | $123.03 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $213.80 Typical High $213.80 | Facility | None | $107.15 | $213.80 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $281.84 | Professional | None | $199.53 | $257.04 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $213.80 | Professional | None | $154.88 | $190.55 | $213.80 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $891.25 | Facility | None | $190.55 | $245.47 | $891.25 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $501.19 | Professional | None | $93.33 | $165.96 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | None | $223.87 | $257.04 | $257.04 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $323.59 | Professional | None | $199.53 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $537.03 | Facility | None | $281.84 | $281.84 | $537.03 |
United Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $169.82 | Professional | None | $85.11 | $95.50 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $44.67 Median $61.66 Typical High $89.13 | Professional | 52 · Reduced service | $44.67 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $24.55 Typical High $35.48 | Professional | 53 · Discontinued | $18.20 | $24.55 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.62 Typical High $26.30 | Professional | 55 · Aftercare only | $13.49 | $18.62 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.30 Typical High $17.78 | Professional | 56 · Pre-op care only | $8.91 | $12.30 | $17.78 |
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· 6th of 51
$186
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.