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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $22.91 Typical High $27.54 | Professional | None | $13.80 | $22.91 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $33.11 Typical High $33.11 | Facility | None | $18.62 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $41.69 | Professional | None | $30.20 | $39.81 | $41.69 |
Hally Health Setting Professional Modifier None Typical Low $28.18 Median $29.51 Typical High $36.31 | Professional | None | $28.18 | $29.51 | $36.31 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $32.36 Typical High $141.25 | Facility | None | $19.95 | $32.36 | $141.25 |
Medica Setting Professional Modifier None Typical Low $14.79 Median $25.12 Typical High $77.62 | Professional | None | $14.79 | $25.12 | $77.62 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $39.81 | Professional | None | $34.67 | $39.81 | $39.81 |
Midlands Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $48.98 Typical High $48.98 | Professional | None | $30.20 | $48.98 | $48.98 |
United Setting Facility Modifier None Typical Low $16.60 Median $43.65 Typical High $83.18 | Facility | None | $16.60 | $43.65 | $83.18 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.79 Typical High $25.70 | Professional | None | $13.80 | $14.79 | $25.70 |
Wellmark Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $6.92 Median $11.48 Typical High $13.80 | Professional | 52 · Reduced service | $6.92 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $4.57 Typical High $5.62 | Professional | 53 · Discontinued | $2.75 | $4.57 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $3.47 Typical High $4.17 | Professional | 55 · Aftercare only | $2.04 | $3.47 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $2.29 Typical High $2.75 | Professional | 56 · Pre-op care only | $1.38 | $2.29 | $2.75 |
Where Iowa sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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
$29.51
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.