How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | None | $75.86 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $173.78 Typical High $204.17 | Professional | None | $114.82 | $173.78 | $204.17 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $346.74 | Professional | None | $83.18 | $109.65 | $346.74 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $199.53 | Facility | None | $138.04 | $177.83 | $199.53 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $512.86 | Professional | None | $117.49 | $169.82 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | None | $141.25 | $173.78 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $346.74 | Professional | None | $131.83 | $141.25 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $199.53 | Professional | None | $85.11 | $158.49 | $199.53 |
United Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $229.09 | Professional | None | $91.20 | $138.04 | $229.09 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $147.91 | Professional | None | $120.23 | $125.89 | $147.91 |
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 $38.02 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $15.14 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $11.48 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.59 | $10.00 | $10.00 |
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· 8th of 51
$148
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.