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 $64.57 Median $131.83 Typical High $263.03 | Facility | None | $64.57 | $131.83 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $165.96 | Professional | None | $44.67 | $85.11 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $138.04 | Facility | None | $79.43 | $102.33 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $131.83 Typical High $204.17 | Professional | None | $93.33 | $131.83 | $204.17 |
Hally Health Setting Professional Modifier None Typical Low $38.90 Median $117.49 Typical High $177.83 | Professional | None | $38.90 | $117.49 | $177.83 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $1,348.96 | Facility | None | $100.00 | $186.21 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $616.60 | Professional | None | $91.20 | $162.18 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $190.55 | Professional | None | $79.43 | $162.18 | $190.55 |
Midlands Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $138.04 | Facility | None | $72.44 | $102.33 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $239.88 | Professional | None | $114.82 | $173.78 | $239.88 |
Oscar Health Setting Professional Modifier None Typical Low $43.65 Median $95.50 Typical High $208.93 | Professional | None | $43.65 | $95.50 | $208.93 |
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 $47.86 Median $97.72 Typical High $190.55 | Professional | None | $47.86 | $97.72 | $190.55 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $239.88 | Professional | None | $79.43 | $93.33 | $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 $19.50 Median $38.90 Typical High $66.07 | Professional | 52 · Reduced service | $19.50 | $38.90 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $15.49 Typical High $26.30 | Professional | 53 · Discontinued | $7.76 | $15.49 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $11.75 Typical High $19.95 | Professional | 55 · Aftercare only | $5.89 | $11.75 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $7.76 Typical High $13.18 | Professional | 56 · Pre-op care only | $3.89 | $7.76 | $13.18 |
Where Iowa sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 4th of 51
$123
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.