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 $28.18 Median $36.31 Typical High $58.88 | Facility | None | $28.18 | $36.31 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $29.51 Typical High $54.95 | Professional | None | $17.38 | $29.51 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $26.30 Typical High $38.90 | Facility | None | $19.05 | $26.30 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $77.62 | Professional | None | $38.90 | $54.95 | $77.62 |
Hally Health Setting Professional Modifier None Typical Low $16.98 Median $39.81 Typical High $69.18 | Professional | None | $16.98 | $39.81 | $69.18 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $75.86 Typical High $1,288.25 | Facility | None | $38.02 | $75.86 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $208.93 | Professional | None | $38.02 | $61.66 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $33.11 Median $53.70 Typical High $67.61 | Professional | None | $33.11 | $53.70 | $67.61 |
Midlands Setting Facility Modifier None Typical Low $19.05 Median $26.92 Typical High $41.69 | Facility | None | $19.05 | $26.92 | $41.69 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $77.62 | Professional | None | $47.86 | $52.48 | $77.62 |
Oscar Health Setting Professional Modifier None Typical Low $16.60 Median $31.62 Typical High $58.88 | Professional | None | $16.60 | $31.62 | $58.88 |
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 $20.89 Median $41.69 Typical High $75.86 | Professional | None | $20.89 | $41.69 | $75.86 |
Wellmark Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $69.18 | Professional | None | $32.36 | $38.02 | $69.18 |
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 $8.51 Median $14.13 Typical High $22.39 | Professional | 52 · Reduced service | $8.51 | $14.13 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $5.62 Typical High $9.12 | Professional | 53 · Discontinued | $3.47 | $5.62 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $4.17 Typical High $6.76 | Professional | 55 · Aftercare only | $2.57 | $4.17 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.82 Typical High $4.47 | Professional | 56 · Pre-op care only | $1.74 | $2.82 | $4.47 |
Where Iowa sits
The same service costs 3.0 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
$45.71
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.