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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $616.60 | Professional | None | $478.63 | $616.60 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,047.13 Typical High $1,318.26 | Professional | None | $512.86 | $1,047.13 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $1,621.81 | Professional | None | $467.74 | $602.56 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $1,318.26 | Facility | None | $562.34 | $1,023.29 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,023.29 Typical High $3,630.78 | Professional | None | $549.54 | $1,023.29 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,348.96 | Professional | None | $891.25 | $1,047.13 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,348.96 | Professional | None | $831.76 | $1,318.26 | $1,348.96 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $1,202.26 | Professional | None | $524.81 | $954.99 | $1,202.26 |
United Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,202.26 | Professional | None | $467.74 | $676.08 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | None | $912.01 | $912.01 | $1,071.52 |
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 $239.88 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $70.79 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $61.66 |
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
$1,023
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.