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 $114.82 Median $134.90 Typical High $151.36 | Facility | None | $114.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $186.21 | Professional | None | $107.15 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $295.12 | Professional | None | $147.91 | $223.87 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $309.03 | Professional | None | $104.71 | $177.83 | $309.03 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $218.78 Typical High $302.00 | Facility | None | $158.49 | $218.78 | $302.00 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $954.99 | Professional | None | $144.54 | $208.93 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $288.40 | Professional | None | $169.82 | $190.55 | $288.40 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $380.19 | Professional | None | $223.87 | $302.00 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $331.13 | Professional | None | $169.82 | $229.09 | $331.13 |
United Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $281.84 | Professional | None | $114.82 | $158.49 | $281.84 |
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 $165.96 Median $173.78 Typical High $257.04 | Professional | None | $165.96 | $173.78 | $257.04 |
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 $54.95 Median $58.88 Typical High $75.86 | Professional | 52 · Reduced service | $54.95 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $17.78 Typical High $22.91 | Professional | 55 · Aftercare only | $16.22 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.96 | $12.02 | $15.14 |
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· 10th 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.