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 $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $204.17 | Professional | None | $120.23 | $134.90 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $316.23 | Facility | None | $213.80 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $371.54 | Professional | None | $245.47 | $316.23 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $354.81 | Professional | None | $186.21 | $213.80 | $354.81 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $309.03 Typical High $933.25 | Facility | None | $239.88 | $309.03 | $933.25 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $724.44 | Professional | None | $169.82 | $295.12 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | None | $316.23 | $316.23 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $407.38 | Professional | None | $204.17 | $281.84 | $407.38 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $794.33 | Facility | None | $416.87 | $416.87 | $794.33 |
United Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $302.00 | Professional | None | $154.88 | $169.82 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $60.26 Median $67.61 Typical High $102.33 | Professional | 52 · Reduced service | $60.26 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $26.92 Typical High $40.74 | Professional | 53 · Discontinued | $23.99 | $26.92 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $20.42 Typical High $30.90 | Professional | 55 · Aftercare only | $17.78 | $20.42 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $13.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.02 | $13.49 | $20.42 |
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
$282
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.