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 $14.45 Median $42.66 Typical High $42.66 | Professional | None | $14.45 | $42.66 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $15.14 | Facility | None | $14.13 | $14.13 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $22.91 Typical High $26.92 | Professional | None | $14.13 | $22.91 | $26.92 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $89.13 Typical High $89.13 | Facility | None | $14.45 | $89.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $22.39 | Professional | None | $10.72 | $11.75 | $22.39 |
Midlands Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.72 Typical High $19.05 | Professional | None | $10.47 | $10.72 | $19.05 |
Wellmark Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
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 $7.24 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $7.24 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $2.88 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $2.14 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $1.45 | $4.27 | $4.27 |
Where Iowa sits
The same service costs 2.7 times more in North Dakota than in Ohio. 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· 2nd of 51
$18.62
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.