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 $45.71 Median $45.71 Typical High $141.25 | Facility | None | $45.71 | $45.71 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $141.25 | Professional | None | $30.90 | $46.77 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $83.18 Typical High $229.09 | Professional | None | $44.67 | $83.18 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $23.44 Median $72.44 Typical High $131.83 | Professional | None | $23.44 | $72.44 | $131.83 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $141.25 Typical High $288.40 | Facility | None | $79.43 | $141.25 | $288.40 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $109.65 Typical High $371.54 | Professional | None | $72.44 | $109.65 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $194.98 | Professional | None | $63.10 | $117.49 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $28.18 Median $63.10 Typical High $208.93 | Professional | None | $28.18 | $63.10 | $208.93 |
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 $30.20 Median $46.77 Typical High $114.82 | Professional | None | $30.20 | $46.77 | $114.82 |
Wellmark Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $173.78 | Professional | None | $46.77 | $54.95 | $173.78 |
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 $15.49 Median $23.44 Typical High $70.79 | Professional | 52 · Reduced service | $15.49 | $23.44 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $9.33 Typical High $28.84 | Professional | 53 · Discontinued | $6.17 | $9.33 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.92 Typical High $21.38 | Professional | 55 · Aftercare only | $4.68 | $6.92 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.68 Typical High $14.13 | Professional | 56 · Pre-op care only | $3.09 | $4.68 | $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 3.5 times more in Hawaii than in Maryland. 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
$95.50
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.