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 $281.84 Median $323.59 Typical High $426.58 | Facility | None | $281.84 | $323.59 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $426.58 | Professional | None | $281.84 | $363.08 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $741.31 | Professional | None | $478.63 | $549.54 | $741.31 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $676.08 | Professional | None | $354.81 | $436.52 | $676.08 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $524.81 Typical High $1,096.48 | Facility | None | $363.08 | $524.81 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $2,754.23 | Professional | None | $501.19 | $741.31 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $741.31 | Professional | None | $549.54 | $707.95 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,202.26 | Professional | None | $537.03 | $741.31 | $1,202.26 |
Oscar Health Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $977.24 | Professional | None | $380.19 | $562.34 | $977.24 |
United Setting Facility Modifier None Typical Low $263.03 Median $446.68 Typical High $562.34 | Facility | None | $263.03 | $446.68 | $562.34 |
United Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $933.25 | Professional | None | $323.59 | $512.86 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $851.14 | Professional | None | $537.03 | $630.96 | $851.14 |
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 $186.21 Median $204.17 Typical High $213.80 | Professional | 52 · Reduced service | $186.21 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $81.28 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $61.66 Typical High $64.57 | Professional | 55 · Aftercare only | $56.23 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $42.66 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $42.66 |
Where Iowa sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 7th of 51
$550
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.