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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $117.49 | Professional | None | $58.88 | $81.28 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $141.25 Typical High $141.25 | Facility | None | $70.79 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $186.21 | Professional | None | $131.83 | $169.82 | $186.21 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $147.91 | Professional | None | $102.33 | $125.89 | $147.91 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $588.84 | Facility | None | $123.03 | $162.18 | $588.84 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $107.15 Typical High $331.13 | Professional | None | $61.66 | $107.15 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | None | $147.91 | $169.82 | $169.82 |
Midlands Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $213.80 | Professional | None | $131.83 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $354.81 | Facility | None | $186.21 | $186.21 | $354.81 |
United Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $112.20 | Professional | None | $56.23 | $63.10 | $112.20 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $29.51 Median $40.74 Typical High $57.54 | Professional | 52 · Reduced service | $29.51 | $40.74 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.22 Typical High $23.44 | Professional | 53 · Discontinued | $11.75 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.02 Typical High $17.38 | Professional | 55 · Aftercare only | $8.91 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.13 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.89 | $8.13 | $11.75 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii 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
$123
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.