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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $95.50 | Professional | None | $50.12 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $125.89 Typical High $125.89 | Facility | None | $91.20 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $165.96 | Professional | None | $117.49 | $151.36 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $112.20 Typical High $131.83 | Professional | None | $97.72 | $112.20 | $131.83 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $537.03 | Facility | None | $77.62 | $125.89 | $537.03 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $295.12 | Professional | None | $56.23 | $97.72 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | None | $131.83 | $151.36 | $151.36 |
Midlands Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $190.55 | Professional | None | $117.49 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $316.23 | Facility | None | $165.96 | $165.96 | $316.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $57.54 Typical High $100.00 | Professional | None | $53.70 | $57.54 | $100.00 |
Wellmark Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $24.55 Median $44.67 Typical High $47.86 | Professional | 52 · Reduced service | $24.55 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $17.78 Typical High $19.05 | Professional | 53 · Discontinued | $10.00 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $13.18 Typical High $14.45 | Professional | 55 · Aftercare only | $7.41 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.91 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.01 | $8.91 | $9.55 |
Where Iowa sits
The same service costs 1.9 times more in Montana than in Virginia. 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
$112
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.