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 $77.62 Median $131.83 Typical High $131.83 | Facility | None | $77.62 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $131.83 | Professional | None | $60.26 | $60.26 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $173.78 | Professional | None | $60.26 | $91.20 | $173.78 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $302.00 | Professional | None | $89.13 | $93.33 | $302.00 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $186.21 | Facility | None | $104.71 | $158.49 | $186.21 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $169.82 | Professional | None | $104.71 | $123.03 | $169.82 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $173.78 | Professional | None | $91.20 | $91.20 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $229.09 | Professional | None | $93.33 | $173.78 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $162.18 | Professional | None | $79.43 | $128.82 | $162.18 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $91.20 | Professional | None | $77.62 | $81.28 | $91.20 |
Wellmark Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $38.02 Median $66.07 Typical High $66.07 | Facility | 52 · Reduced service | $38.02 | $66.07 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.49 Median $26.92 Typical High $26.92 | Facility | 53 · Discontinued | $15.49 | $26.92 | $26.92 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $19.95 Typical High $19.95 | Facility | 55 · Aftercare only | $11.48 | $19.95 | $19.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.76 Median $13.18 Typical High $13.18 | Facility | 56 · Pre-op care only | $7.76 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $66.07 | Professional | 52 · Reduced service | $30.20 | $30.20 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $26.92 | Professional | 53 · Discontinued | $12.02 | $12.02 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $8.91 Typical High $19.95 | Professional | 55 · Aftercare only | $8.91 | $8.91 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $13.18 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 5th of 51
$91.20
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.