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 $141.25 Median $151.36 Typical High $229.09 | Facility | None | $141.25 | $151.36 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
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 $151.36 Median $190.55 Typical High $199.53 | Professional | None | $151.36 | $190.55 | $199.53 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $309.03 | Professional | None | $151.36 | $151.36 | $309.03 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $398.11 | Facility | None | $186.21 | $223.87 | $398.11 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $691.83 | Professional | None | $151.36 | $165.96 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $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 $190.55 Median $239.88 Typical High $645.65 | Professional | None | $190.55 | $239.88 | $645.65 |
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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $70.79 Median $70.79 Typical High $75.86 | Professional | 52 · Reduced service | $70.79 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $15.14 |
Where Iowa sits
The same service costs 2.9 times more in Wyoming than in North Carolina. 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· 22nd of 51
$151
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.