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 $5.75 Median $8.71 Typical High $21.38 | Facility | None | $5.75 | $8.71 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.89 | Professional | None | $5.75 | $5.75 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $6.92 Typical High $7.76 | Professional | None | $5.50 | $6.92 | $7.76 |
Hally Health Setting Professional Modifier None Typical Low $5.75 Median $12.02 Typical High $21.38 | Professional | None | $5.75 | $12.02 | $21.38 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $6.92 Typical High $8.51 | Facility | None | $5.75 | $6.92 | $8.51 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $6.92 Typical High $25.12 | Professional | None | $5.75 | $6.92 | $25.12 |
Midlands Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $8.51 | Professional | None | $6.92 | $6.92 | $8.51 |
Midlands Setting Professional Modifier None Typical Low $7.59 Median $7.76 Typical High $15.14 | Professional | None | $7.59 | $7.76 | $15.14 |
Oscar Health Setting Professional Modifier None Typical Low $6.17 Median $10.23 Typical High $12.30 | Professional | None | $6.17 | $10.23 | $12.30 |
United Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.03 Typical High $6.76 | Professional | None | $5.75 | $6.03 | $6.76 |
Wellmark Setting Facility Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | None | $6.31 | $6.31 | $6.31 |
Wellmark Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | None | $6.31 | $6.31 | $6.31 |
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 $2.88 Median $2.88 Typical High $2.95 | Professional | 52 · Reduced service | $2.88 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.15 Typical High $1.17 | Professional | 53 · Discontinued | $1.15 | $1.15 | $1.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.89 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.59 |
Where Iowa sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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
$6.31
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.