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 $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $18.62 Typical High $24.55 | Professional | None | $12.59 | $18.62 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $38.90 Typical High $60.26 | Professional | None | $23.99 | $38.90 | $60.26 |
Hally Health Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $42.66 | Professional | None | $18.62 | $23.99 | $42.66 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $31.62 Typical High $66.07 | Facility | None | $14.79 | $31.62 | $66.07 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $45.71 Typical High $147.91 | Professional | None | $23.99 | $45.71 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $66.07 | Professional | None | $38.90 | $38.90 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $37.15 Median $43.65 Typical High $66.07 | Professional | None | $37.15 | $43.65 | $66.07 |
United Setting Professional Modifier None Typical Low $21.38 Median $34.67 Typical High $60.26 | Professional | None | $21.38 | $34.67 | $60.26 |
Wellmark Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | None | $30.20 | $30.20 | $35.48 |
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 $6.31 Median $9.33 Typical High $12.30 | Professional | 52 · Reduced service | $6.31 | $9.33 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $3.72 Typical High $4.90 | Professional | 53 · Discontinued | $2.51 | $3.72 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $2.75 Typical High $3.72 | Professional | 55 · Aftercare only | $1.86 | $2.75 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.86 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.26 | $1.86 | $2.45 |
Where Iowa sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 13th of 51
$35.48
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.