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 $28.84 Median $28.84 Typical High $50.12 | Facility | None | $28.84 | $28.84 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $32.36 Typical High $50.12 | Professional | None | $18.20 | $32.36 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $34.67 Typical High $48.98 | Facility | None | $26.30 | $34.67 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $56.23 Typical High $89.13 | Professional | None | $39.81 | $56.23 | $89.13 |
Hally Health Setting Professional Modifier None Typical Low $17.38 Median $44.67 Typical High $95.50 | Professional | None | $17.38 | $44.67 | $95.50 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $97.72 Typical High $1,288.25 | Facility | None | $42.66 | $97.72 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $75.86 Typical High $338.84 | Professional | None | $38.90 | $75.86 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $33.88 Median $60.26 Typical High $74.13 | Professional | None | $33.88 | $60.26 | $74.13 |
Midlands Setting Facility Modifier None Typical Low $26.30 Median $34.67 Typical High $52.48 | Facility | None | $26.30 | $34.67 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $75.86 Typical High $100.00 | Professional | None | $50.12 | $75.86 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $16.22 Median $33.11 Typical High $66.07 | Professional | None | $16.22 | $33.11 | $66.07 |
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 $22.39 Median $46.77 Typical High $89.13 | Professional | None | $22.39 | $46.77 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $77.62 | Professional | None | $32.36 | $38.02 | $77.62 |
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 $9.12 Median $14.79 Typical High $25.12 | Professional | 52 · Reduced service | $9.12 | $14.79 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $5.89 Typical High $10.00 | Professional | 53 · Discontinued | $3.63 | $5.89 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $4.47 Typical High $7.59 | Professional | 55 · Aftercare only | $2.69 | $4.47 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.95 Typical High $5.01 | Professional | 56 · Pre-op care only | $1.82 | $2.95 | $5.01 |
Where Iowa sits
The same service costs 3.5 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· 3rd of 51
$60.26
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.