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 $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,548.82 Typical High $1,995.26 | Professional | None | $758.58 | $1,548.82 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $933.25 Typical High $2,570.40 | Professional | None | $707.95 | $933.25 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,513.56 Typical High $2,041.74 | Facility | None | $831.76 | $1,513.56 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,479.11 Typical High $5,370.32 | Professional | None | $812.83 | $1,479.11 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,548.82 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,995.26 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $812.83 Median $1,479.11 Typical High $1,862.09 | Professional | None | $812.83 | $1,479.11 | $1,862.09 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,737.80 | Professional | None | $691.83 | $1,000.00 | $1,737.80 |
Wellmark Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $363.08 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $363.08 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $147.91 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $93.33 | $93.33 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in New York. 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· 3rd of 51
$1,479
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.