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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $19.95 Typical High $21.88 | Professional | None | $11.48 | $19.95 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $28.84 Typical High $28.84 | Facility | None | $16.60 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $36.31 Typical High $37.15 | Professional | None | $26.92 | $36.31 | $37.15 |
Hally Health Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $33.88 | Professional | None | $24.55 | $25.70 | $33.88 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $28.18 Typical High $131.83 | Facility | None | $17.38 | $28.18 | $131.83 |
Medica Setting Professional Modifier None Typical Low $12.59 Median $23.44 Typical High $72.44 | Professional | None | $12.59 | $23.44 | $72.44 |
Midlands Setting Professional Modifier None Typical Low $29.51 Median $37.15 Typical High $37.15 | Professional | None | $29.51 | $37.15 | $37.15 |
Midlands Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Midlands Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $42.66 | Professional | None | $28.84 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $16.22 Median $40.74 Typical High $77.62 | Facility | None | $16.22 | $40.74 | $77.62 |
United Setting Professional Modifier None Typical Low $12.30 Median $12.88 Typical High $22.39 | Professional | None | $12.30 | $12.88 | $22.39 |
Wellmark Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $5.75 Median $10.00 Typical High $10.96 | Professional | 52 · Reduced service | $5.75 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $3.98 Typical High $4.37 | Professional | 53 · Discontinued | $2.29 | $3.98 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $2.95 Typical High $3.24 | Professional | 55 · Aftercare only | $1.74 | $2.95 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $2.00 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.15 | $2.00 | $2.19 |
Where Iowa sits
The same service costs 3.0 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· 11th of 51
$25.70
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.