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 $141.25 Median $141.25 Typical High $331.13 | Facility | None | $141.25 | $141.25 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $141.25 | Professional | None | $100.00 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $245.47 Typical High $269.15 | Professional | None | $107.15 | $245.47 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $371.54 | Professional | None | $83.18 | $154.88 | $371.54 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $245.47 Typical High $812.83 | Facility | None | $169.82 | $245.47 | $812.83 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $208.93 Typical High $3,162.28 | Professional | None | $70.79 | $208.93 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $269.15 | Professional | None | $208.93 | $245.47 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $302.00 | Professional | None | $204.17 | $257.04 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $229.09 | Professional | None | $100.00 | $190.55 | $229.09 |
United Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $1,047.13 | Facility | None | $489.78 | $831.76 | $1,047.13 |
United Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $229.09 | Professional | None | $100.00 | $134.90 | $229.09 |
Wellmark Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | None | $194.98 | $194.98 | $229.09 |
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 $50.12 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $50.12 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $19.95 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $14.79 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.00 | $14.13 | $14.13 |
Where Iowa sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 6th of 51
$195
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.