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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $24.55 Typical High $34.67 | Professional | None | $17.78 | $24.55 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $42.66 Typical High $42.66 | Facility | None | $25.70 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $51.29 Typical High $54.95 | Professional | None | $38.90 | $51.29 | $54.95 |
Hally Health Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $47.86 | Professional | None | $30.90 | $38.02 | $47.86 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $48.98 Typical High $177.83 | Facility | None | $37.15 | $48.98 | $177.83 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $32.36 Typical High $100.00 | Professional | None | $18.62 | $32.36 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $51.29 Typical High $51.29 | Professional | None | $44.67 | $51.29 | $51.29 |
Midlands Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Midlands Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $63.10 | Professional | None | $38.90 | $63.10 | $63.10 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $107.15 | Facility | None | $56.23 | $56.23 | $107.15 |
United Setting Professional Modifier None Typical Low $16.98 Median $19.05 Typical High $33.88 | Professional | None | $16.98 | $19.05 | $33.88 |
Wellmark Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
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 $8.91 Median $12.30 Typical High $17.38 | Professional | 52 · Reduced service | $8.91 | $12.30 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.90 Typical High $7.08 | Professional | 53 · Discontinued | $3.55 | $4.90 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.63 Typical High $5.25 | Professional | 55 · Aftercare only | $2.69 | $3.63 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.45 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.78 | $2.45 | $3.47 |
Where Iowa sits
The same service costs 2.2 times more in Montana than in New Jersey. 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
$38.02
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.