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 $177.83 Median $177.83 Typical High $234.42 | Facility | None | $177.83 | $177.83 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $234.42 | Professional | None | $109.65 | $177.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $147.91 | Facility | None | $79.43 | $120.23 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $346.74 | Professional | None | $251.19 | $316.23 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $316.23 | Professional | None | $104.71 | $194.98 | $316.23 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $331.13 Typical High $1,288.25 | Facility | None | $134.90 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $1,096.48 | Professional | None | $181.97 | $302.00 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $338.84 | Professional | None | $213.80 | $281.84 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $117.49 Typical High $147.91 | Facility | None | $79.43 | $117.49 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $398.11 | Professional | None | $218.78 | $309.03 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $316.23 | Professional | None | $109.65 | $199.53 | $316.23 |
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 $125.89 Median $204.17 Typical High $363.08 | Professional | None | $125.89 | $204.17 | $363.08 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $354.81 | Professional | None | $208.93 | $245.47 | $354.81 |
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 $54.95 Median $89.13 Typical High $117.49 | Professional | 52 · Reduced service | $54.95 | $89.13 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $35.48 Typical High $46.77 | Professional | 53 · Discontinued | $22.39 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $23.44 |
Where Iowa sits
The same service costs 4.3 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
$251
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.