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 $125.89 Typical High $213.80 | Facility | None | $64.57 | $125.89 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $138.04 | Professional | None | $40.74 | $69.18 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $83.18 | Facility | None | $77.62 | $77.62 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $165.96 | Professional | None | $93.33 | $114.82 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $38.02 Median $93.33 Typical High $151.36 | Professional | None | $38.02 | $93.33 | $151.36 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $165.96 Typical High $1,348.96 | Facility | None | $100.00 | $165.96 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $120.23 Typical High $501.19 | Professional | None | $75.86 | $120.23 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $151.36 | Professional | None | $79.43 | $128.82 | $151.36 |
Midlands Setting Facility Modifier None Typical Low $77.62 Median $83.18 Typical High $91.20 | Facility | None | $77.62 | $83.18 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $125.89 Typical High $194.98 | Professional | None | $75.86 | $125.89 | $194.98 |
Oscar Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $3,311.31 | Facility | None | $1,122.02 | $2,398.83 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $165.96 | Professional | None | $44.67 | $83.18 | $165.96 |
United Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $1,995.26 | Facility | None | $173.78 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $151.36 | Professional | None | $44.67 | $79.43 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $194.98 | Professional | None | $85.11 | $100.00 | $194.98 |
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 $20.42 Median $32.36 Typical High $53.70 | Professional | 52 · Reduced service | $20.42 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $12.88 Typical High $21.38 | Professional | 53 · Discontinued | $8.13 | $12.88 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $9.55 Typical High $16.22 | Professional | 55 · Aftercare only | $6.17 | $9.55 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.46 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.07 | $6.46 | $10.72 |
Where Iowa sits
The same service costs 4.0 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· 7th of 51
$100
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.