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 $63.10 Median $63.10 Typical High $141.25 | Facility | None | $63.10 | $63.10 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $141.25 | Professional | None | $42.66 | $64.57 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $102.33 Typical High $234.42 | Professional | None | $57.54 | $102.33 | $234.42 |
Hally Health Setting Professional Modifier None Typical Low $31.62 Median $70.79 Typical High $134.90 | Professional | None | $31.62 | $70.79 | $134.90 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $173.78 Typical High $288.40 | Facility | None | $109.65 | $173.78 | $288.40 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $363.08 | Professional | None | $97.72 | $123.03 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $194.98 | Professional | None | $87.10 | $141.25 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $38.02 Median $85.11 Typical High $204.17 | Professional | None | $38.02 | $85.11 | $204.17 |
United Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $416.87 | Facility | None | $199.53 | $331.13 | $416.87 |
United Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $117.49 | Professional | None | $38.02 | $60.26 | $117.49 |
Wellmark Setting Professional Modifier None Typical Low $63.10 Median $74.13 Typical High $169.82 | Professional | None | $63.10 | $74.13 | $169.82 |
5 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 $21.38 Median $32.36 Typical High $70.79 | Professional | 52 · Reduced service | $21.38 | $32.36 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.88 Typical High $28.18 | Professional | 53 · Discontinued | $8.51 | $12.88 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.55 Typical High $20.89 | Professional | 55 · Aftercare only | $6.31 | $9.55 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.31 Typical High $14.13 | Professional | 56 · Pre-op care only | $4.27 | $6.31 | $14.13 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Iowa sits
The same service costs 2.5 times more in Alaska than in Washington, DC. 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· 4th of 51
$102
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.