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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | None | $83.18 | $83.18 | $89.13 |
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 $95.50 Median $190.55 Typical High $245.47 | Professional | None | $95.50 | $190.55 | $245.47 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $138.04 Typical High $457.09 | Professional | None | $89.13 | $138.04 | $457.09 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $223.87 Typical High $269.15 | Facility | None | $109.65 | $223.87 | $269.15 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $436.52 | Professional | None | $93.33 | $95.50 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $275.42 | Professional | None | $151.36 | $190.55 | $275.42 |
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 $131.83 Median $131.83 Typical High $275.42 | Professional | None | $131.83 | $131.83 | $275.42 |
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $41.69 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $41.69 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | 53 · Discontinued | $16.60 | $16.60 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.91 |
Where Iowa sits
The same service costs 2.1 times more in Wyoming than in Kentucky. 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
$110
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.