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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $489.78 Typical High $724.44 | Professional | None | $426.58 | $489.78 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,122.02 | Facility | None | $758.58 | $1,122.02 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,348.96 | Professional | None | $891.25 | $1,122.02 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,122.02 | Professional | None | $660.69 | $758.58 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,096.48 Typical High $3,388.44 | Facility | None | $870.96 | $1,096.48 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $2,570.40 | Professional | None | $602.56 | $1,047.13 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,445.44 | Professional | None | $724.44 | $1,023.29 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,884.03 | Facility | None | $1,479.11 | $1,479.11 | $2,884.03 |
United Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $1,096.48 | Professional | None | $549.54 | $616.60 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $213.80 Median $245.47 Typical High $363.08 | Professional | 52 · Reduced service | $213.80 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $144.54 | Professional | 53 · Discontinued | $85.11 | $97.72 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $109.65 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $48.98 Typical High $72.44 | Professional | 56 · Pre-op care only | $42.66 | $48.98 | $72.44 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 3rd of 51
$1,000
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.