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 $95.50 Median $112.20 Typical High $131.83 | Facility | None | $95.50 | $112.20 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $162.18 | Professional | None | $89.13 | $117.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $251.19 | Professional | None | $125.89 | $186.21 | $251.19 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $151.36 Typical High $269.15 | Professional | None | $87.10 | $151.36 | $269.15 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $186.21 Typical High $263.03 | Facility | None | $131.83 | $186.21 | $263.03 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $812.83 | Professional | None | $123.03 | $177.83 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $251.19 | Professional | None | $138.04 | $165.96 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $323.59 | Professional | None | $186.21 | $257.04 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $281.84 | Professional | None | $138.04 | $186.21 | $281.84 |
United Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $239.88 | Professional | None | $95.50 | $134.90 | $239.88 |
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 $138.04 Median $141.25 Typical High $223.87 | Professional | None | $138.04 | $141.25 | $223.87 |
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 $44.67 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $44.67 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $19.95 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $13.18 |
Where Iowa sits
The same service costs 2.7 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· 12th of 51
$158
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.