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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $70.79 | Professional | None | $36.31 | $50.12 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $87.10 Typical High $87.10 | Facility | None | $43.65 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $112.20 | Professional | None | $79.43 | $104.71 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $77.62 Typical High $213.80 | Professional | None | $63.10 | $77.62 | $213.80 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $363.08 | Facility | None | $75.86 | $100.00 | $363.08 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $66.07 Typical High $204.17 | Professional | None | $38.02 | $66.07 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $104.71 | Professional | None | $91.20 | $104.71 | $104.71 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $128.82 | Professional | None | $79.43 | $128.82 | $128.82 |
United Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $218.78 | Facility | None | $114.82 | $114.82 | $218.78 |
United Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $69.18 | Professional | None | $34.67 | $38.90 | $69.18 |
Wellmark Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $18.20 Median $25.12 Typical High $35.48 | Professional | 52 · Reduced service | $18.20 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $10.00 Typical High $14.45 | Professional | 53 · Discontinued | $7.24 | $10.00 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $7.41 Typical High $10.72 | Professional | 55 · Aftercare only | $5.50 | $7.41 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.01 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.63 | $5.01 | $7.08 |
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· 3rd of 51
$77.62
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.