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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $67.61 | Professional | None | $63.10 | $63.10 | $67.61 |
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 $66.07 Median $190.55 Typical High $190.55 | Professional | None | $66.07 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $275.42 | Professional | None | $67.61 | $102.33 | $275.42 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $120.23 Typical High $208.93 | Facility | None | $51.29 | $120.23 | $208.93 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $776.25 | Professional | None | $66.07 | $67.61 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $302.00 | Professional | None | $123.03 | $190.55 | $302.00 |
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 $112.20 Median $112.20 Typical High $123.03 | Professional | None | $112.20 | $112.20 | $123.03 |
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Wellmark Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $31.62 Median $31.62 Typical High $33.88 | Professional | 52 · Reduced service | $31.62 | $31.62 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $13.49 | Professional | 53 · Discontinued | $12.59 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $10.00 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $6.76 |
Where Iowa sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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
$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.