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 $64.57 Median $74.13 Typical High $87.10 | Facility | None | $64.57 | $74.13 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $165.96 | Professional | None | $64.57 | $87.10 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $218.78 | Professional | None | $154.88 | $158.49 | $218.78 |
Hally Health Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $371.54 | Professional | None | $91.20 | $151.36 | $371.54 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $199.53 Typical High $288.40 | Facility | None | $181.97 | $199.53 | $288.40 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $794.33 | Professional | None | $141.25 | $190.55 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | None | $154.88 | $154.88 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $269.15 | Professional | None | $177.83 | $218.78 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $165.96 Typical High $204.17 | Professional | None | $93.33 | $165.96 | $204.17 |
United Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $302.00 | Professional | None | $134.90 | $177.83 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $162.18 | Professional | None | $138.04 | $158.49 | $162.18 |
3 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 $40.74 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.71 | $8.71 |
Where Iowa sits
The same service costs 2.0 times more in Alaska than in Washington, DC. 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
$162
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.