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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | None | $85.11 | $85.11 | $91.20 |
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 $69.18 Median $190.55 Typical High $190.55 | Professional | None | $69.18 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $165.96 | Professional | None | $87.10 | $120.23 | $165.96 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $89.13 Typical High $158.49 | Facility | None | $75.86 | $89.13 | $158.49 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $69.18 Typical High $302.00 | Professional | None | $67.61 | $69.18 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $190.55 | Professional | None | $77.62 | $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 $77.62 Median $77.62 Typical High $104.71 | Professional | None | $77.62 | $77.62 | $104.71 |
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Wellmark Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $42.66 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $16.98 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.12 |
Where Iowa sits
The same service costs 2.1 times more in Alaska than in Montana. 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· 47th of 51
$91.20
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.