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 $120.23 Median $134.90 Typical High $158.49 | Facility | None | $120.23 | $134.90 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $190.55 | Professional | None | $120.23 | $134.90 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $263.03 Typical High $281.84 | Professional | None | $128.82 | $263.03 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $446.68 | Professional | None | $128.82 | $208.93 | $446.68 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $257.04 Typical High $338.84 | Facility | None | $229.09 | $257.04 | $338.84 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $1,000.00 | Professional | None | $181.97 | $269.15 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | None | $263.03 | $263.03 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $346.74 | Professional | None | $263.03 | $281.84 | $346.74 |
Oscar Health Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $275.42 | Professional | None | $131.83 | $154.88 | $275.42 |
United Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $380.19 | Professional | None | $169.82 | $218.78 | $380.19 |
Wellmark Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $190.55 | Professional | None | $162.18 | $190.55 | $190.55 |
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 $69.18 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $13.80 | $15.85 | $15.85 |
Where Iowa sits
The same service costs 2.4 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· 16th of 51
$191
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.