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 $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | None | $58.88 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $97.72 | Professional | None | $72.44 | $97.72 | $97.72 |
Hally Health Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $83.18 | Professional | None | $54.95 | $57.54 | $83.18 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $79.43 Typical High $147.91 | Facility | None | $44.67 | $79.43 | $147.91 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $398.11 | Professional | None | $50.12 | $79.43 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Oscar Health Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $141.25 | Professional | None | $61.66 | $117.49 | $141.25 |
United Setting Facility Modifier None Typical Low $43.65 Median $72.44 Typical High $91.20 | Facility | None | $43.65 | $72.44 | $91.20 |
United Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $77.62 | Professional | None | $50.12 | $57.54 | $77.62 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | None | $134.90 | $134.90 | $158.49 |
4 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 $28.84 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $28.84 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $11.75 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $8.71 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.89 | $6.46 | $6.46 |
Where Iowa sits
The same service costs 2.6 times more in Alaska than in Utah. 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· 3rd of 51
$87.10
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.