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 $100.00 Median $100.00 Typical High $141.25 | Facility | None | $100.00 | $100.00 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $173.78 | Professional | None | $63.10 | $100.00 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $144.54 | Facility | None | $93.33 | $109.65 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $213.80 | Professional | None | $144.54 | $177.83 | $213.80 |
Hally Health Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $177.83 | Professional | None | $57.54 | $125.89 | $177.83 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $1,348.96 | Facility | None | $112.20 | $199.53 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $660.69 | Professional | None | $102.33 | $169.82 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $204.17 | Professional | None | $123.03 | $173.78 | $204.17 |
Midlands Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $144.54 | Facility | None | $81.28 | $112.20 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $245.47 | Professional | None | $123.03 | $173.78 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $204.17 | Professional | None | $63.10 | $117.49 | $204.17 |
United Setting Facility Modifier None Typical Low $223.87 Median $758.58 Typical High $1,995.26 | Facility | None | $223.87 | $758.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $66.07 Median $109.65 Typical High $204.17 | Professional | None | $66.07 | $109.65 | $204.17 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $239.88 | Professional | None | $123.03 | $144.54 | $239.88 |
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 $31.62 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $31.62 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $19.95 Typical High $28.18 | Professional | 53 · Discontinued | $12.59 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $14.79 Typical High $21.38 | Professional | 55 · Aftercare only | $9.55 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.00 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.31 | $10.00 | $14.13 |
Where Iowa sits
The same service costs 3.7 times more in Alaska 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· 6th of 51
$145
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.