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 $30.90 Median $30.90 Typical High $114.82 | Facility | None | $30.90 | $30.90 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $30.90 Typical High $114.82 | Professional | None | $20.42 | $30.90 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $60.26 Typical High $186.21 | Professional | None | $28.18 | $60.26 | $186.21 |
Hally Health Setting Professional Modifier None Typical Low $15.49 Median $58.88 Typical High $97.72 | Professional | None | $15.49 | $58.88 | $97.72 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $114.82 Typical High $288.40 | Facility | None | $52.48 | $114.82 | $288.40 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $302.00 | Professional | None | $47.86 | $83.18 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $95.50 Typical High $158.49 | Professional | None | $41.69 | $95.50 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Oscar Health Setting Professional Modifier None Typical Low $18.62 Median $42.66 Typical High $169.82 | Professional | None | $18.62 | $42.66 | $169.82 |
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 $20.89 Median $38.02 Typical High $91.20 | Professional | None | $20.89 | $38.02 | $91.20 |
Wellmark Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $141.25 | Professional | None | $31.62 | $37.15 | $141.25 |
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 $10.23 Median $15.49 Typical High $57.54 | Professional | 52 · Reduced service | $10.23 | $15.49 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $6.17 Typical High $22.91 | Professional | 53 · Discontinued | $4.07 | $6.17 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.68 Typical High $17.38 | Professional | 55 · Aftercare only | $3.09 | $4.68 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $3.09 Typical High $11.48 | Professional | 56 · Pre-op care only | $2.04 | $3.09 | $11.48 |
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 4.4 times more in Hawaii 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
$75.86
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.