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 $138.04 Median $138.04 Typical High $199.53 | Facility | None | $138.04 | $138.04 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $199.53 | Professional | None | $87.10 | $138.04 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $147.91 Typical High $194.98 | Facility | None | $125.89 | $147.91 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $302.00 | Professional | None | $199.53 | $251.19 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $245.47 | Professional | None | $81.28 | $173.78 | $245.47 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $281.84 Typical High $1,288.25 | Facility | None | $151.36 | $281.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $239.88 Typical High $933.25 | Professional | None | $144.54 | $239.88 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $288.40 | Professional | None | $169.82 | $245.47 | $288.40 |
Midlands Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $194.98 | Facility | None | $109.65 | $151.36 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $346.74 | Professional | None | $169.82 | $239.88 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $295.12 | Professional | None | $91.20 | $165.96 | $295.12 |
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 $95.50 Median $154.88 Typical High $288.40 | Professional | None | $95.50 | $154.88 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $169.82 Median $199.53 Typical High $338.84 | Professional | None | $169.82 | $199.53 | $338.84 |
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 $43.65 Median $69.18 Typical High $100.00 | Professional | 52 · Reduced service | $43.65 | $69.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $27.54 Typical High $39.81 | Professional | 53 · Discontinued | $17.38 | $27.54 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $20.42 Typical High $30.20 | Professional | 55 · Aftercare only | $12.88 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.80 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.71 | $13.80 | $19.95 |
Where Iowa sits
The same service costs 3.6 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
$200
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.