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 $112.20 Median $199.53 Typical High $295.12 | Facility | None | $112.20 | $199.53 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $190.55 | Professional | None | $89.13 | $117.49 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $302.00 | Professional | None | $144.54 | $263.03 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $354.81 | Professional | None | $123.03 | $199.53 | $354.81 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $257.04 Typical High $331.13 | Facility | None | $194.98 | $257.04 | $331.13 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $1,047.13 | Professional | None | $165.96 | $245.47 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $229.09 Typical High $288.40 | Professional | None | $213.80 | $229.09 | $288.40 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $380.19 | Professional | None | $229.09 | $288.40 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $380.19 | Professional | None | $128.82 | $234.42 | $380.19 |
United Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $302.00 | Professional | None | $131.83 | $169.82 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $245.47 | Professional | None | $158.49 | $162.18 | $245.47 |
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 $58.88 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $58.88 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $17.38 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.75 | $12.59 | $14.79 |
Medica Setting Professional Modifier 25 · Same-day visit Typical Low $245.47 Median $338.84 Typical High $512.86 | Professional | 25 · Same-day visit | $245.47 | $338.84 | $512.86 |
Where Iowa sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 11th of 51
$204
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.