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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $42.66 Typical High $46.77 | Professional | None | $24.55 | $42.66 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $61.66 Typical High $61.66 | Facility | None | $34.67 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $83.18 | Professional | None | $57.54 | $79.43 | $83.18 |
Hally Health Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $79.43 | Professional | None | $53.70 | $64.57 | $79.43 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $60.26 Typical High $281.84 | Facility | None | $38.02 | $60.26 | $281.84 |
Medica Setting Professional Modifier None Typical Low $27.54 Median $50.12 Typical High $158.49 | Professional | None | $27.54 | $50.12 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $83.18 Typical High $83.18 | Professional | None | $64.57 | $83.18 | $83.18 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $93.33 | Professional | None | $63.10 | $93.33 | $93.33 |
United Setting Facility Modifier None Typical Low $29.51 Median $91.20 Typical High $173.78 | Facility | None | $29.51 | $91.20 | $173.78 |
United Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $48.98 | Professional | None | $27.54 | $27.54 | $48.98 |
Wellmark Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $12.59 Median $21.38 Typical High $23.44 | Professional | 52 · Reduced service | $12.59 | $21.38 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $8.71 Typical High $9.33 | Professional | 53 · Discontinued | $5.01 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $6.46 Typical High $6.92 | Professional | 55 · Aftercare only | $3.80 | $6.46 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $4.27 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.51 | $4.27 | $4.68 |
Where Iowa sits
The same service costs 2.5 times more in Hawaii 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· 6th of 51
$54.95
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.