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 $18.62 Median $18.62 Typical High $20.89 | Professional | None | $18.62 | $18.62 | $20.89 |
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 $21.88 Median $190.55 Typical High $190.55 | Professional | None | $21.88 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $16.98 Median $19.95 Typical High $151.36 | Professional | None | $16.98 | $19.95 | $151.36 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $26.92 Typical High $33.11 | Facility | None | $23.44 | $26.92 | $33.11 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $21.38 Typical High $91.20 | Professional | None | $20.89 | $21.38 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $23.99 Median $190.55 Typical High $190.55 | Professional | None | $23.99 | $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 $23.99 Median $23.99 Typical High $30.90 | Professional | None | $23.99 | $23.99 | $30.90 |
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 $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Wellmark Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
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 $9.33 Median $9.33 Typical High $10.00 | Professional | 52 · Reduced service | $9.33 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.98 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.02 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $2.00 |
Where Iowa sits
The same service costs 6.3 times more in Massachusetts than in Indiana. 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· 40th of 51
$23.44
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.