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 $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | None | $31.62 | $31.62 | $33.88 |
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 $34.67 Median $190.55 Typical High $190.55 | Professional | None | $34.67 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $151.36 | Professional | None | $28.84 | $33.88 | $151.36 |
Medica Setting Facility Modifier None Typical Low $35.48 Median $40.74 Typical High $57.54 | Facility | None | $35.48 | $40.74 | $57.54 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $112.20 | Professional | None | $33.88 | $34.67 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $36.31 Median $190.55 Typical High $190.55 | Professional | None | $36.31 | $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 $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Wellmark Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $15.85 Median $15.85 Typical High $16.98 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.13 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.39 |
Where Iowa sits
The same service costs 4.2 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· 44th 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.