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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $70.79 Typical High $75.86 | Professional | None | $39.81 | $70.79 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $102.33 Typical High $102.33 | Facility | None | $50.12 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $131.83 | Professional | None | $93.33 | $120.23 | $131.83 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $112.20 | Professional | None | $87.10 | $91.20 | $112.20 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $100.00 Typical High $426.58 | Facility | None | $61.66 | $100.00 | $426.58 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $234.42 | Professional | None | $44.67 | $77.62 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | None | $104.71 | $120.23 | $120.23 |
Midlands Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $151.36 | Professional | None | $93.33 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $109.65 Median $131.83 Typical High $257.04 | Facility | None | $109.65 | $131.83 | $257.04 |
United Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $79.43 | Professional | None | $42.66 | $45.71 | $79.43 |
Wellmark Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $19.95 Median $35.48 Typical High $38.02 | Professional | 52 · Reduced service | $19.95 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $7.94 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $10.47 Typical High $11.48 | Professional | 55 · Aftercare only | $5.89 | $10.47 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $7.08 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.98 | $7.08 | $7.59 |
Where Iowa sits
The same service costs 2.8 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
$91.20
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.