How much rates vary
Facilitymedian $195 · 10th to 90th $195 to $468Professionalmedian $195 · 10th to 90th $162 to $372
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 $263.03 Median $467.74 Typical High $467.74 | Facility | None | $263.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $467.74 | Professional | None | $162.18 | $162.18 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $257.04 | Professional | None | $162.18 | $213.80 | $257.04 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $776.25 | Professional | None | $177.83 | $416.87 | $776.25 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $467.74 | Facility | None | $154.88 | $234.42 | $467.74 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $257.04 | Professional | None | $154.88 | $186.21 | $257.04 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $436.52 | Professional | None | $239.88 | $257.04 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $371.54 | Professional | None | $186.21 | $302.00 | $371.54 |
United Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $208.93 | Professional | None | $177.83 | $186.21 | $208.93 |
Wellmark Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $87.10 Median $234.42 Typical High $234.42 | Facility | 52 · Reduced service | $87.10 | $234.42 | $234.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $35.48 Median $93.33 Typical High $93.33 | Facility | 53 · Discontinued | $35.48 | $93.33 | $93.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $26.30 Median $70.79 Typical High $70.79 | Facility | 55 · Aftercare only | $26.30 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.78 Median $46.77 Typical High $46.77 | Facility | 56 · Pre-op care only | $17.78 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $234.42 | Professional | 52 · Reduced service | $79.43 | $79.43 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $93.33 | Professional | 53 · Discontinued | $32.36 | $32.36 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $70.79 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $46.77 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $46.77 |
Where Iowa sits
The same service costs 1.9 times more in Wyoming than in Nevada. 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· 6th of 51
$195
WY $302NV $162
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.