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 $134.90 Median $134.90 Typical High $199.53 | Facility | None | $134.90 | $134.90 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $199.53 | Professional | None | $85.11 | $134.90 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $194.98 | Facility | None | $117.49 | $141.25 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $302.00 | Professional | None | $186.21 | $245.47 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $239.88 | Professional | None | $79.43 | $173.78 | $239.88 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $263.03 Typical High $1,288.25 | Facility | None | $147.91 | $263.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $933.25 | Professional | None | $141.25 | $229.09 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $263.03 | Professional | None | $158.49 | $223.87 | $263.03 |
Midlands Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $194.98 | Facility | None | $95.50 | $144.54 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $338.84 | Professional | None | $165.96 | $229.09 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $295.12 | Professional | None | $89.13 | $162.18 | $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 $91.20 Median $147.91 Typical High $269.15 | Professional | None | $91.20 | $147.91 | $269.15 |
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 $42.66 Median $67.61 Typical High $100.00 | Professional | 52 · Reduced service | $42.66 | $67.61 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $26.92 Typical High $39.81 | Professional | 53 · Discontinued | $16.98 | $26.92 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $20.42 Typical High $30.20 | Professional | 55 · Aftercare only | $12.59 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $13.49 Typical High $19.95 | Professional | 56 · Pre-op care only | $8.51 | $13.49 | $19.95 |
Where Iowa sits
The same service costs 3.7 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
$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.