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 $21.88 Median $21.88 Typical High $21.88 | Facility | None | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | None | $18.62 | $21.88 | $21.88 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $25.12 Typical High $26.30 | Professional | None | $21.38 | $25.12 | $26.30 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $16.98 Typical High $38.02 | Professional | None | $12.88 | $16.98 | $38.02 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $24.55 Typical High $44.67 | Facility | None | $20.89 | $24.55 | $44.67 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $23.99 Typical High $50.12 | Professional | None | $20.89 | $23.99 | $50.12 |
Midlands Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Oscar Health Setting Facility Modifier None Typical Low $45.71 Median $173.78 Typical High $245.47 | Facility | None | $45.71 | $173.78 | $245.47 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $53.70 | Facility | None | $20.89 | $20.89 | $53.70 |
United Setting Professional Modifier None Typical Low $20.89 Median $23.44 Typical High $25.70 | Professional | None | $20.89 | $23.44 | $25.70 |
Wellmark Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
8 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 Facility Modifier 52 · Reduced service Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | 52 · Reduced service | $10.96 | $10.96 | $10.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | 53 · Discontinued | $4.37 | $4.37 | $4.37 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.31 | Facility | 55 · Aftercare only | $3.31 | $3.31 | $3.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.19 | Facility | 56 · Pre-op care only | $2.19 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | 52 · Reduced service | $9.33 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $4.37 | Professional | 53 · Discontinued | $3.72 | $3.72 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $3.31 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $2.19 |
Where Iowa sits
The same service costs 2.1 times more in Alabama than in Rhode Island. 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· 15th of 51
$21.88
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.