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 $138.04 Median $154.88 Typical High $181.97 | Facility | None | $138.04 | $154.88 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $309.03 | Professional | None | $138.04 | $181.97 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $467.74 | Professional | None | $263.03 | $331.13 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $676.08 | Professional | None | $190.55 | $281.84 | $676.08 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $398.11 Typical High $467.74 | Facility | None | $316.23 | $398.11 | $467.74 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $1,288.25 | Professional | None | $239.88 | $363.08 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Professional | None | $331.13 | $331.13 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $478.63 | Professional | None | $380.19 | $436.52 | $478.63 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $436.52 | Professional | None | $194.98 | $354.81 | $436.52 |
United Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $489.78 | Professional | None | $218.78 | $295.12 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $346.74 | Professional | None | $295.12 | $346.74 | $346.74 |
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 $85.11 Median $91.20 Typical High $91.20 | Professional | 52 · Reduced service | $85.11 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $25.70 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $16.98 | $18.20 | $18.20 |
Where Iowa sits
The same service costs 2.4 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
$347
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.