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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $26.30 Typical High $38.02 | Professional | None | $19.50 | $26.30 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $45.71 Typical High $45.71 | Facility | None | $22.91 | $45.71 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $54.95 Typical High $60.26 | Professional | None | $42.66 | $54.95 | $60.26 |
Hally Health Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $53.70 | Professional | None | $33.11 | $41.69 | $53.70 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $190.55 | Facility | None | $39.81 | $52.48 | $190.55 |
Medica Setting Professional Modifier None Typical Low $19.95 Median $35.48 Typical High $107.15 | Professional | None | $19.95 | $35.48 | $107.15 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $54.95 | Professional | None | $47.86 | $54.95 | $54.95 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $42.66 Median $69.18 Typical High $69.18 | Professional | None | $42.66 | $69.18 | $69.18 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $114.82 | Facility | None | $60.26 | $60.26 | $114.82 |
United Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $36.31 | Professional | None | $18.62 | $20.42 | $36.31 |
Wellmark Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $9.55 Median $13.18 Typical High $19.05 | Professional | 52 · Reduced service | $9.55 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $5.25 Typical High $7.59 | Professional | 53 · Discontinued | $3.89 | $5.25 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.98 Typical High $5.62 | Professional | 55 · Aftercare only | $2.88 | $3.98 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $2.63 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.95 | $2.63 | $3.80 |
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
$39.81
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.