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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $67.61 Typical High $74.13 | Professional | None | $38.02 | $67.61 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $97.72 Typical High $97.72 | Facility | None | $69.18 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $125.89 | Professional | None | $89.13 | $117.49 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $102.33 | Professional | None | $74.13 | $87.10 | $102.33 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $407.38 | Facility | None | $60.26 | $95.50 | $407.38 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $74.13 Typical High $229.09 | Professional | None | $43.65 | $74.13 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | None | $102.33 | $117.49 | $117.49 |
Midlands Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $147.91 | Professional | None | $89.13 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $245.47 | Facility | None | $128.82 | $128.82 | $245.47 |
United Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $77.62 | Professional | None | $40.74 | $43.65 | $77.62 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $19.05 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $19.05 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $7.59 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $5.75 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.80 | $6.76 | $7.41 |
Where Iowa sits
The same service costs 2.0 times more in Montana than in South Carolina. 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· 5th of 51
$87.10
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.