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 $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $275.42 | Professional | None | $213.80 | $263.03 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $478.63 Typical High $630.96 | Professional | None | $371.54 | $478.63 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $660.69 | Professional | None | $186.21 | $275.42 | $660.69 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $489.78 Typical High $1,513.56 | Facility | None | $229.09 | $489.78 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $691.83 | Professional | None | $239.88 | $398.11 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $630.96 | Professional | None | $407.38 | $407.38 | $630.96 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $467.74 | Professional | None | $204.17 | $389.05 | $467.74 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $562.34 | Professional | None | $218.78 | $316.23 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | None | $316.23 | $380.19 | $380.19 |
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 $114.82 Median $131.83 Typical High $131.83 | Professional | 52 · Reduced service | $114.82 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $52.48 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $33.88 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $26.30 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $26.30 | $26.30 |
Where Iowa sits
The same service costs 3.0 times more in Wisconsin 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
$398
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.