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 $27.54 Median $27.54 Typical High $27.54 | Facility | None | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | None | $27.54 | $27.54 | $30.20 |
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 $25.12 Median $190.55 Typical High $190.55 | Professional | None | $25.12 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $26.30 Median $30.20 Typical High $151.36 | Professional | None | $26.30 | $30.20 | $151.36 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $39.81 Typical High $69.18 | Facility | None | $29.51 | $39.81 | $69.18 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $30.90 Typical High $134.90 | Professional | None | $29.51 | $30.90 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $38.02 Median $190.55 Typical High $190.55 | Professional | None | $38.02 | $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 $38.02 Median $38.02 Typical High $45.71 | Professional | None | $38.02 | $38.02 | $45.71 |
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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Wellmark Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $13.80 Median $13.80 Typical High $14.79 | Professional | 52 · Reduced service | $13.80 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $6.03 | Professional | 53 · Discontinued | $5.62 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.17 Typical High $4.47 | Professional | 55 · Aftercare only | $4.17 | $4.17 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $3.02 |
Where Iowa sits
The same service costs 4.2 times more in Wyoming than in Pennsylvania. 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· 45th of 51
$30.90
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.