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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $85.11 | Professional | None | $42.66 | $58.88 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $102.33 Typical High $102.33 | Facility | None | $57.54 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $131.83 | Professional | None | $93.33 | $123.03 | $131.83 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $107.15 | Professional | None | $74.13 | $91.20 | $107.15 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $117.49 Typical High $426.58 | Facility | None | $89.13 | $117.49 | $426.58 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $239.88 | Professional | None | $44.67 | $77.62 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $123.03 | Professional | None | $107.15 | $123.03 | $123.03 |
Midlands Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | None | $93.33 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $257.04 | Facility | None | $134.90 | $134.90 | $257.04 |
United Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $81.28 | Professional | None | $40.74 | $45.71 | $81.28 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $21.38 Median $29.51 Typical High $41.69 | Professional | 52 · Reduced service | $21.38 | $29.51 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $11.75 Typical High $16.98 | Professional | 53 · Discontinued | $8.51 | $11.75 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.71 Typical High $12.59 | Professional | 55 · Aftercare only | $6.46 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.89 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.27 | $5.89 | $8.32 |
Where Iowa sits
The same service costs 2.3 times more in Montana than in Florida. 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
$89.13
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.