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 $79.43 Median $104.71 Typical High $114.82 | Facility | None | $79.43 | $104.71 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $141.25 | Professional | None | $74.13 | $104.71 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $223.87 | Professional | None | $112.20 | $165.96 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $72.44 Median $141.25 Typical High $245.47 | Professional | None | $72.44 | $141.25 | $245.47 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $158.49 Typical High $234.42 | Facility | None | $109.65 | $158.49 | $234.42 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $707.95 | Professional | None | $104.71 | $158.49 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $218.78 | Professional | None | $114.82 | $144.54 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $288.40 | Professional | None | $154.88 | $229.09 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $251.19 | Professional | None | $123.03 | $154.88 | $251.19 |
United Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $208.93 | Professional | None | $81.28 | $120.23 | $208.93 |
Wellmark Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Wellmark Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $199.53 | Professional | None | $112.20 | $117.49 | $199.53 |
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 $38.02 Median $44.67 Typical High $57.54 | Professional | 52 · Reduced service | $38.02 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.18 Typical High $17.38 | Professional | 55 · Aftercare only | $11.22 | $13.18 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.91 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $8.91 | $11.48 |
Where Iowa sits
The same service costs 2.8 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· 10th of 51
$141
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.