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 $66.07 Median $70.79 Typical High $107.15 | Facility | None | $66.07 | $70.79 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $70.79 | Professional | None | $66.07 | $66.07 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $269.15 | Facility | None | $190.55 | $239.88 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $181.97 Typical High $190.55 | Professional | None | $28.84 | $181.97 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $128.82 | Professional | None | $57.54 | $70.79 | $128.82 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $85.11 Typical High $109.65 | Facility | None | $19.50 | $85.11 | $109.65 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $398.11 | Professional | None | $38.90 | $70.79 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $28.84 Median $190.55 Typical High $190.55 | Professional | None | $28.84 | $190.55 | $190.55 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $239.88 Typical High $302.00 | Facility | None | $190.55 | $239.88 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $19.05 Median $56.23 Typical High $57.54 | Professional | None | $19.05 | $56.23 | $57.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | None | $125.89 | $125.89 | $134.90 |
Wellmark Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Wellmark Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $33.11 Median $33.11 Typical High $35.48 | Professional | 52 · Reduced service | $33.11 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $14.45 | Professional | 53 · Discontinued | $13.18 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.08 |
Where Iowa sits
The same service costs 2.0 times more in North Dakota than in Maryland. 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· 50th of 51
$70.79
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.