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 $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | None | $117.49 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $316.23 | Professional | None | $131.83 | $288.40 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $512.86 | Professional | None | $112.20 | $199.53 | $512.86 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $338.84 | Facility | None | $204.17 | $251.19 | $338.84 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $1,174.90 | Professional | None | $154.88 | $281.84 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $331.13 | Professional | None | $245.47 | $288.40 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $269.15 Typical High $331.13 | Professional | None | $218.78 | $269.15 | $331.13 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $199.53 Typical High $251.19 | Professional | None | $109.65 | $199.53 | $251.19 |
United Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $331.13 | Professional | None | $134.90 | $190.55 | $331.13 |
Wellmark Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | None | $190.55 | $190.55 | $223.87 |
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 $58.88 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $58.88 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $23.44 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $17.78 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.75 | $15.14 | $15.14 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in Utah. 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
$224
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.