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 $165.96 Median $165.96 Typical High $229.09 | Facility | None | $165.96 | $165.96 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $229.09 | Professional | None | $104.71 | $165.96 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $199.53 | Facility | None | $131.83 | $158.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $338.84 | Professional | None | $239.88 | $288.40 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $199.53 Typical High $281.84 | Professional | None | $100.00 | $199.53 | $281.84 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $316.23 Typical High $1,288.25 | Facility | None | $158.49 | $316.23 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $1,071.52 | Professional | None | $169.82 | $288.40 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $331.13 | Professional | None | $204.17 | $275.42 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $117.49 Median $158.49 Typical High $199.53 | Facility | None | $117.49 | $158.49 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $389.05 | Professional | None | $208.93 | $288.40 | $389.05 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $331.13 | Professional | None | $107.15 | $194.98 | $331.13 |
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 $114.82 Median $186.21 Typical High $338.84 | Professional | None | $114.82 | $186.21 | $338.84 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $380.19 | Professional | None | $204.17 | $239.88 | $380.19 |
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 $52.48 Median $83.18 Typical High $112.20 | Professional | 52 · Reduced service | $52.48 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.11 Typical High $45.71 | Professional | 53 · Discontinued | $20.89 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $33.88 | Professional | 55 · Aftercare only | $15.85 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.60 Typical High $22.91 | Professional | 56 · Pre-op care only | $10.47 | $16.60 | $22.91 |
Where Iowa sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 5th of 51
$240
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.