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 $25.12 Median $40.74 Typical High $48.98 | Facility | None | $25.12 | $40.74 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $40.74 | Professional | None | $25.12 | $25.12 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $34.67 | Professional | None | $19.95 | $19.95 | $34.67 |
Hally Health Setting Professional Modifier None Typical Low $21.38 Median $79.43 Typical High $141.25 | Professional | None | $21.38 | $79.43 | $141.25 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $32.36 Typical High $40.74 | Facility | None | $25.12 | $32.36 | $40.74 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $77.62 | Professional | None | $20.89 | $25.70 | $77.62 |
Midlands Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $34.67 | Professional | None | $19.95 | $19.95 | $34.67 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $34.67 Typical High $77.62 | Professional | None | $30.20 | $34.67 | $77.62 |
Oscar Health Setting Professional Modifier None Typical Low $17.78 Median $29.51 Typical High $48.98 | Professional | None | $17.78 | $29.51 | $48.98 |
United Setting Professional Modifier None Typical Low $16.60 Median $17.38 Typical High $74.13 | Professional | None | $16.60 | $17.38 | $74.13 |
Wellmark Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
Wellmark Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
8 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 Facility Modifier 52 · Reduced service Typical Low $12.30 Median $20.42 Typical High $20.42 | Facility | 52 · Reduced service | $12.30 | $20.42 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.01 Median $8.13 Typical High $8.13 | Facility | 53 · Discontinued | $5.01 | $8.13 | $8.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.72 Median $6.17 Typical High $6.17 | Facility | 55 · Aftercare only | $3.72 | $6.17 | $6.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.45 Median $4.07 Typical High $4.07 | Facility | 56 · Pre-op care only | $2.45 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $20.42 | Professional | 52 · Reduced service | $12.30 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $8.13 | Professional | 53 · Discontinued | $5.01 | $5.01 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $6.17 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $4.07 |
Where Iowa sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 50th of 51
$22.39
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.