How much rates vary
Facilitymedian $79 · 10th to 90th $79 to $110Professionalmedian $85 · 10th to 90th $71 to $115
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 $74.13 Median $107.15 Typical High $109.65 | Facility | None | $74.13 | $107.15 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $107.15 | Professional | None | $70.79 | $70.79 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $112.20 | Professional | None | $70.79 | $89.13 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $223.87 | Professional | None | $75.86 | $95.50 | $223.87 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $144.54 | Facility | None | $75.86 | $100.00 | $144.54 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $114.82 | Professional | None | $75.86 | $91.20 | $114.82 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | None | $89.13 | $89.13 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $204.17 | Professional | None | $95.50 | $112.20 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $154.88 | Professional | None | $79.43 | $131.83 | $154.88 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $87.10 | Professional | None | $74.13 | $77.62 | $87.10 |
Wellmark Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $36.31 Median $53.70 Typical High $54.95 | Facility | 52 · Reduced service | $36.31 | $53.70 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $21.38 Typical High $22.39 | Facility | 53 · Discontinued | $14.79 | $21.38 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $16.22 Typical High $16.60 | Facility | 55 · Aftercare only | $10.96 | $16.22 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.72 Typical High $10.96 | Facility | 56 · Pre-op care only | $7.41 | $10.72 | $10.96 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $35.48 Typical High $53.70 | Professional | 52 · Reduced service | $35.48 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $21.38 | Professional | 53 · Discontinued | $14.13 | $14.13 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $16.22 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $10.72 |
Where Iowa sits
The same service costs 1.5 times more in Wyoming than in Florida. 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
$85.11
WY $107FL $70.79
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.