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 $8.71 Median $8.71 Typical High $8.71 | Facility | None | $8.71 | $8.71 | $8.71 |
Aetna Setting Professional Modifier None Typical Low $4.79 Median $8.71 Typical High $9.33 | Professional | None | $4.79 | $8.71 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $12.30 Typical High $12.30 | Facility | None | $7.08 | $12.30 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $15.85 Typical High $16.60 | Professional | None | $11.48 | $15.85 | $16.60 |
Hally Health Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $14.13 | Professional | None | $10.72 | $11.75 | $14.13 |
Medica Setting Facility Modifier None Typical Low $7.59 Median $12.02 Typical High $79.43 | Facility | None | $7.59 | $12.02 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.50 Median $9.77 Typical High $32.36 | Professional | None | $5.50 | $9.77 | $32.36 |
Midlands Setting Professional Modifier None Typical Low $12.88 Median $16.60 Typical High $16.60 | Professional | None | $12.88 | $16.60 | $16.60 |
Midlands Setting Facility Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Facility | None | $12.30 | $12.30 | $12.30 |
Midlands Setting Professional Modifier None Typical Low $12.59 Median $18.62 Typical High $18.62 | Professional | None | $12.59 | $18.62 | $18.62 |
United Setting Facility Modifier None Typical Low $7.94 Median $18.20 Typical High $34.67 | Facility | None | $7.94 | $18.20 | $34.67 |
United Setting Professional Modifier None Typical Low $5.50 Median $5.62 Typical High $9.77 | Professional | None | $5.50 | $5.62 | $9.77 |
Wellmark Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
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 $2.40 Median $4.27 Typical High $4.68 | Professional | 52 · Reduced service | $2.40 | $4.27 | $4.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $1.74 Typical High $1.86 | Professional | 53 · Discontinued | $0.95 | $1.74 | $1.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $1.29 Typical High $1.38 | Professional | 55 · Aftercare only | $0.72 | $1.29 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.85 Typical High $0.93 | Professional | 56 · Pre-op care only | $0.48 | $0.85 | $0.93 |
Where Iowa sits
The same service costs 3.5 times more in Montana than in Kansas. 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
$10.96
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.