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 $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $30.90 Typical High $44.67 | Professional | None | $22.91 | $30.90 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $54.95 Typical High $54.95 | Facility | None | $27.54 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $70.79 | Professional | None | $50.12 | $66.07 | $70.79 |
Hally Health Setting Professional Modifier None Typical Low $38.90 Median $48.98 Typical High $57.54 | Professional | None | $38.90 | $48.98 | $57.54 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $63.10 Typical High $229.09 | Facility | None | $47.86 | $63.10 | $229.09 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $41.69 Typical High $125.89 | Professional | None | $23.99 | $41.69 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $66.07 | Professional | None | $57.54 | $66.07 | $66.07 |
Midlands Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $81.28 | Professional | None | $50.12 | $81.28 | $81.28 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $138.04 | Facility | None | $70.79 | $70.79 | $138.04 |
United Setting Professional Modifier None Typical Low $21.88 Median $24.55 Typical High $42.66 | Professional | None | $21.88 | $24.55 | $42.66 |
Wellmark Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $11.48 Median $15.49 Typical High $22.39 | Professional | 52 · Reduced service | $11.48 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $6.31 Typical High $8.91 | Professional | 53 · Discontinued | $4.57 | $6.31 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $4.68 Typical High $6.76 | Professional | 55 · Aftercare only | $3.47 | $4.68 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.09 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.29 | $3.09 | $4.47 |
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
$47.86
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.