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 $234.42 Median $234.42 Typical High $537.03 | Facility | None | $234.42 | $234.42 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $234.42 Typical High $234.42 | Professional | None | $162.18 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $426.58 Typical High $446.68 | Professional | None | $181.97 | $426.58 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $1,258.93 | Professional | None | $138.04 | $257.04 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $398.11 Typical High $812.83 | Facility | None | $275.42 | $398.11 | $812.83 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $354.81 Typical High $1,122.02 | Professional | None | $81.28 | $354.81 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | None | $363.08 | $426.58 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $426.58 Typical High $501.19 | Professional | None | $346.74 | $426.58 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $316.23 Typical High $380.19 | Professional | None | $165.96 | $316.23 | $380.19 |
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 $173.78 Median $229.09 Typical High $398.11 | Professional | None | $173.78 | $229.09 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
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 $81.28 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $32.36 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $24.55 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.22 | $23.44 | $23.44 |
Where Iowa sits
The same service costs 2.9 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· 8th of 51
$324
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.