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 $54.95 | Facility | None | $45.71 | $45.71 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $45.71 Typical High $54.95 | Professional | None | $35.48 | $45.71 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $89.13 Typical High $100.00 | Professional | None | $38.90 | $89.13 | $100.00 |
Hally Health Setting Professional Modifier None Typical Low $27.54 Median $38.02 Typical High $66.07 | Professional | None | $27.54 | $38.02 | $66.07 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $97.72 Typical High $331.13 | Facility | None | $53.70 | $97.72 | $331.13 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $83.18 Typical High $234.42 | Professional | None | $38.02 | $83.18 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $89.13 | Professional | None | $75.86 | $85.11 | $89.13 |
Oscar Health Setting Professional Modifier None Typical Low $31.62 Median $58.88 Typical High $93.33 | Professional | None | $31.62 | $58.88 | $93.33 |
United Setting Facility Modifier None Typical Low $323.59 Median $537.03 Typical High $676.08 | Facility | None | $323.59 | $537.03 | $676.08 |
United Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $72.44 | Professional | None | $37.15 | $51.29 | $72.44 |
Wellmark Setting Professional Modifier None Typical Low $52.48 Median $54.95 Typical High $75.86 | Professional | None | $52.48 | $54.95 | $75.86 |
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 $17.38 Median $22.91 Typical High $27.54 | Professional | 52 · Reduced service | $17.38 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.12 Typical High $10.96 | Professional | 53 · Discontinued | $7.08 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.92 Typical High $8.13 | Professional | 55 · Aftercare only | $5.25 | $6.92 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.57 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.55 | $4.57 | $5.50 |
Where Iowa sits
The same service costs 2.9 times more in Alaska than in Kentucky. 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
$64.57
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.