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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $269.15 | Facility | None | $204.17 | $239.88 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $190.55 | Professional | None | $87.10 | $190.55 | $190.55 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $218.78 | Professional | None | $97.72 | $107.15 | $218.78 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $269.15 | Facility | None | $95.50 | $120.23 | $269.15 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $776.25 | Professional | None | $100.00 | $112.20 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $302.00 | Professional | None | $87.10 | $190.55 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $223.87 Typical High $269.15 | Facility | None | $107.15 | $223.87 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $309.03 | Professional | None | $87.10 | $154.88 | $309.03 |
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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Wellmark Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $45.71 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.79 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.77 |
Where Iowa sits
The same service costs 2.0 times more in Alaska 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· 44th of 51
$107
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.