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 $29.51 Median $29.51 Typical High $54.95 | Facility | None | $29.51 | $29.51 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $35.48 Typical High $54.95 | Professional | None | $18.20 | $35.48 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $54.95 | Facility | None | $51.29 | $51.29 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $57.54 Typical High $95.50 | Professional | None | $40.74 | $57.54 | $95.50 |
Hally Health Setting Professional Modifier None Typical Low $17.78 Median $48.98 Typical High $91.20 | Professional | None | $17.78 | $48.98 | $91.20 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $1,288.25 | Facility | None | $48.98 | $102.33 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $39.81 Median $79.43 Typical High $323.59 | Professional | None | $39.81 | $79.43 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $66.07 Typical High $79.43 | Professional | None | $34.67 | $66.07 | $79.43 |
Midlands Setting Facility Modifier None Typical Low $51.29 Median $54.95 Typical High $60.26 | Facility | None | $51.29 | $54.95 | $60.26 |
Midlands Setting Professional Modifier None Typical Low $48.98 Median $69.18 Typical High $95.50 | Professional | None | $48.98 | $69.18 | $95.50 |
Oscar Health Setting Professional Modifier None Typical Low $16.22 Median $34.67 Typical High $74.13 | Professional | None | $16.22 | $34.67 | $74.13 |
United Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $1,995.26 | Facility | None | $173.78 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $22.91 Median $47.86 Typical High $95.50 | Professional | None | $22.91 | $47.86 | $95.50 |
Wellmark Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $85.11 | Professional | None | $32.36 | $38.02 | $85.11 |
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 $15.85 Typical High $27.54 | Professional | 52 · Reduced service | $9.12 | $15.85 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $6.31 Typical High $10.96 | Professional | 53 · Discontinued | $3.72 | $6.31 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $4.79 Typical High $8.13 | Professional | 55 · Aftercare only | $2.75 | $4.79 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $3.16 Typical High $5.50 | Professional | 56 · Pre-op care only | $1.82 | $3.16 | $5.50 |
Where Iowa sits
The same service costs 3.8 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· 6th of 51
$53.70
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.