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 $85.11 Median $104.71 Typical High $120.23 | Facility | None | $85.11 | $104.71 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $147.91 | Professional | None | $77.62 | $104.71 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $229.09 | Professional | None | $114.82 | $165.96 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $239.88 | Professional | None | $77.62 | $138.04 | $239.88 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $165.96 Typical High $239.88 | Facility | None | $114.82 | $165.96 | $239.88 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $741.31 | Professional | None | $112.20 | $162.18 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $223.87 | Professional | None | $123.03 | $151.36 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $295.12 | Professional | None | $162.18 | $239.88 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $263.03 | Professional | None | $123.03 | $165.96 | $263.03 |
United Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $218.78 | Professional | None | $85.11 | $120.23 | $218.78 |
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 $120.23 Median $125.89 Typical High $208.93 | Professional | None | $120.23 | $125.89 | $208.93 |
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 $39.81 Median $45.71 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $13.80 Typical High $18.20 | Professional | 55 · Aftercare only | $12.02 | $13.80 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $9.33 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $9.33 | $12.02 |
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· 11th of 51
$145
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.