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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $58.88 Typical High $64.57 | Professional | None | $33.11 | $58.88 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $85.11 Typical High $85.11 | Facility | None | $43.65 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $109.65 | Professional | None | $77.62 | $102.33 | $109.65 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $114.82 | Professional | None | $74.13 | $75.86 | $114.82 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $354.81 | Facility | None | $51.29 | $83.18 | $354.81 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $199.53 | Professional | None | $38.02 | $64.57 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | None | $89.13 | $102.33 | $102.33 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $125.89 | Professional | None | $77.62 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $213.80 | Facility | None | $112.20 | $112.20 | $213.80 |
United Setting Professional Modifier None Typical Low $35.48 Median $38.02 Typical High $67.61 | Professional | None | $35.48 | $38.02 | $67.61 |
Wellmark Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
2 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 55 · Aftercare only Typical Low $5.01 Median $8.91 Typical High $9.55 | Professional | 55 · Aftercare only | $5.01 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.89 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.31 | $5.89 | $6.46 |
Where Iowa sits
The same service costs 2.2 times more in Montana than in West 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· 3rd of 51
$75.86
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.