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 $104.71 Median $181.97 Typical High $208.93 | Facility | None | $104.71 | $181.97 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | None | $81.28 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $204.17 | Professional | None | $131.83 | $190.55 | $204.17 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $144.54 | Professional | None | $74.13 | $112.20 | $144.54 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $158.49 Typical High $208.93 | Facility | None | $91.20 | $158.49 | $208.93 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $154.88 Typical High $457.09 | Professional | None | $107.15 | $154.88 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Professional | None | $147.91 | $147.91 | $151.36 |
Oscar Health Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $144.54 | Facility | None | $93.33 | $93.33 | $144.54 |
United Setting Professional Modifier None Typical Low $43.65 Median $125.89 Typical High $229.09 | Professional | None | $43.65 | $125.89 | $229.09 |
Wellmark Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | None | $102.33 | $102.33 | $125.89 |
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 $40.74 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $40.74 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $16.22 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $12.30 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.13 | $10.47 | $10.47 |
Where Iowa sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 7th of 51
$126
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.