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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $69.18 | Professional | None | $34.67 | $47.86 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $83.18 Typical High $83.18 | Facility | None | $41.69 | $83.18 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $109.65 | Professional | None | $77.62 | $100.00 | $109.65 |
Hally Health Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $87.10 | Professional | None | $60.26 | $75.86 | $87.10 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $95.50 Typical High $346.74 | Facility | None | $72.44 | $95.50 | $346.74 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $64.57 Typical High $194.98 | Professional | None | $36.31 | $64.57 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | None | $87.10 | $100.00 | $100.00 |
Midlands Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $125.89 | Professional | None | $77.62 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $208.93 | Facility | None | $109.65 | $109.65 | $208.93 |
United Setting Professional Modifier None Typical Low $33.11 Median $37.15 Typical High $66.07 | Professional | None | $33.11 | $37.15 | $66.07 |
Wellmark Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $17.38 Median $23.99 Typical High $34.67 | Professional | 52 · Reduced service | $17.38 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.55 Typical High $13.80 | Professional | 53 · Discontinued | $7.08 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.24 Typical High $10.23 | Professional | 55 · Aftercare only | $5.25 | $7.24 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.79 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.47 | $4.79 | $6.92 |
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· 4th of 51
$74.13
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.