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 $107.15 Median $107.15 Typical High $154.88 | Facility | None | $107.15 | $107.15 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $213.80 | Professional | None | $67.61 | $107.15 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $154.88 | Facility | None | $79.43 | $117.49 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $234.42 | Professional | None | $154.88 | $190.55 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $61.66 Median $134.90 Typical High $190.55 | Professional | None | $61.66 | $134.90 | $190.55 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $213.80 Typical High $1,288.25 | Facility | None | $123.03 | $213.80 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $724.44 | Professional | None | $112.20 | $186.21 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $223.87 | Professional | None | $131.83 | $190.55 | $223.87 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $154.88 | Facility | None | $79.43 | $117.49 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $186.21 Typical High $269.15 | Professional | None | $128.82 | $186.21 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $229.09 | Professional | None | $69.18 | $128.82 | $229.09 |
United Setting Facility Modifier None Typical Low $213.80 Median $575.44 Typical High $1,995.26 | Facility | None | $213.80 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $223.87 | Professional | None | $72.44 | $120.23 | $223.87 |
Wellmark Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $263.03 | Professional | None | $131.83 | $154.88 | $263.03 |
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 $33.88 Median $53.70 Typical High $77.62 | Professional | 52 · Reduced service | $33.88 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.38 Typical High $30.90 | Professional | 53 · Discontinued | $13.49 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.22 Typical High $23.44 | Professional | 55 · Aftercare only | $10.23 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.72 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.76 | $10.72 | $15.49 |
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
$155
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.