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 $17.38 Median $17.38 Typical High $17.38 | Facility | None | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $17.38 Typical High $25.70 | Professional | None | $13.18 | $17.38 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $30.20 Typical High $30.20 | Facility | None | $15.85 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $41.69 | Professional | None | $28.18 | $38.02 | $41.69 |
Hally Health Setting Professional Modifier None Typical Low $22.91 Median $28.18 Typical High $33.11 | Professional | None | $22.91 | $28.18 | $33.11 |
Medica Setting Facility Modifier None Typical Low $18.62 Median $30.20 Typical High $131.83 | Facility | None | $18.62 | $30.20 | $131.83 |
Medica Setting Professional Modifier None Typical Low $13.49 Median $23.99 Typical High $74.13 | Professional | None | $13.49 | $23.99 | $74.13 |
Midlands Setting Professional Modifier None Typical Low $31.62 Median $38.02 Typical High $38.02 | Professional | None | $31.62 | $38.02 | $38.02 |
Midlands Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Midlands Setting Professional Modifier None Typical Low $28.84 Median $45.71 Typical High $45.71 | Professional | None | $28.84 | $45.71 | $45.71 |
United Setting Facility Modifier None Typical Low $34.67 Median $41.69 Typical High $79.43 | Facility | None | $34.67 | $41.69 | $79.43 |
United Setting Professional Modifier None Typical Low $12.59 Median $13.49 Typical High $23.99 | Professional | None | $12.59 | $13.49 | $23.99 |
Wellmark Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
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 $6.61 Median $8.71 Typical High $12.88 | Professional | 52 · Reduced service | $6.61 | $8.71 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $3.47 Typical High $5.25 | Professional | 53 · Discontinued | $2.63 | $3.47 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.63 Typical High $3.89 | Professional | 55 · Aftercare only | $2.00 | $2.63 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.74 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.32 | $1.74 | $2.57 |
Where Iowa sits
The same service costs 5.5 times more in Kansas 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
$26.92
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.