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 $22.39 Median $22.39 Typical High $22.39 | Facility | None | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $22.39 Typical High $32.36 | Professional | None | $16.60 | $22.39 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $38.90 Typical High $38.90 | Facility | None | $24.55 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $46.77 Typical High $51.29 | Professional | None | $36.31 | $46.77 | $51.29 |
Hally Health Setting Professional Modifier None Typical Low $28.18 Median $35.48 Typical High $43.65 | Professional | None | $28.18 | $35.48 | $43.65 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $44.67 Typical High $165.96 | Facility | None | $33.88 | $44.67 | $165.96 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $30.20 Typical High $91.20 | Professional | None | $16.98 | $30.20 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | None | $40.74 | $46.77 | $46.77 |
Midlands Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Midlands Setting Professional Modifier None Typical Low $36.31 Median $58.88 Typical High $58.88 | Professional | None | $36.31 | $58.88 | $58.88 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $100.00 | Facility | None | $51.29 | $51.29 | $100.00 |
United Setting Professional Modifier None Typical Low $15.85 Median $17.38 Typical High $30.90 | Professional | None | $15.85 | $17.38 | $30.90 |
Wellmark Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $8.32 Median $11.22 Typical High $16.22 | Professional | 52 · Reduced service | $8.32 | $11.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $4.47 Typical High $6.46 | Professional | 53 · Discontinued | $3.31 | $4.47 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $3.39 Typical High $4.79 | Professional | 55 · Aftercare only | $2.45 | $3.39 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $2.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.66 | $2.24 | $3.24 |
Where Iowa sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$34.67
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.