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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $109.65 | Professional | None | $54.95 | $74.13 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $128.82 Typical High $128.82 | Facility | None | $70.79 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $165.96 | Professional | None | $125.89 | $154.88 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $131.83 | Professional | None | $93.33 | $114.82 | $131.83 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $537.03 | Facility | None | $81.28 | $125.89 | $537.03 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $302.00 | Professional | None | $57.54 | $97.72 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | None | $134.90 | $154.88 | $154.88 |
Midlands Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $63.10 Median $169.82 Typical High $323.59 | Facility | None | $63.10 | $169.82 | $323.59 |
United Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $102.33 | Professional | None | $51.29 | $57.54 | $102.33 |
Wellmark Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $26.92 Median $37.15 Typical High $52.48 | Professional | 52 · Reduced service | $26.92 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.79 Typical High $15.14 | Professional | 53 · Discontinued | $10.96 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $8.13 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.41 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.37 | $7.41 | $10.72 |
Where Iowa sits
The same service costs 2.4 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· 7th of 51
$112
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.