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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $32.36 Typical High $46.77 | Professional | None | $23.44 | $32.36 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $56.23 Typical High $56.23 | Facility | None | $33.88 | $56.23 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $67.61 Typical High $72.44 | Professional | None | $51.29 | $67.61 | $72.44 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $74.13 | Professional | None | $40.74 | $50.12 | $74.13 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $64.57 Typical High $234.42 | Facility | None | $48.98 | $64.57 | $234.42 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $42.66 Typical High $131.83 | Professional | None | $24.55 | $42.66 | $131.83 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | None | $58.88 | $67.61 | $67.61 |
Midlands Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
Midlands Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $85.11 | Professional | None | $51.29 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $141.25 | Facility | None | $74.13 | $74.13 | $141.25 |
United Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $44.67 | Professional | None | $22.39 | $25.12 | $44.67 |
Wellmark Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $11.75 Median $16.22 Typical High $22.91 | Professional | 52 · Reduced service | $11.75 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $6.46 Typical High $9.33 | Professional | 53 · Discontinued | $4.68 | $6.46 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.79 Typical High $6.92 | Professional | 55 · Aftercare only | $3.55 | $4.79 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.24 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.34 | $3.24 | $4.68 |
Where Iowa sits
The same service costs 2.2 times more in Montana than in Arizona. 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· 5th of 51
$50.12
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.