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 $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $851.14 | Professional | None | $501.19 | $562.34 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,318.26 Typical High $1,318.26 | Facility | None | $851.14 | $1,318.26 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,318.26 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,778.28 | Professional | None | $758.58 | $870.96 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $3,890.45 | Facility | None | $1,000.00 | $1,288.25 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $3,019.95 | Professional | None | $707.95 | $1,230.27 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,412.54 | Professional | None | $1,318.26 | $1,318.26 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,659.59 | Professional | None | $851.14 | $1,174.90 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,311.31 | Facility | None | $1,737.80 | $1,737.80 | $3,311.31 |
United Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $1,258.93 | Professional | None | $630.96 | $707.95 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $251.19 Median $281.84 Typical High $426.58 | Professional | 52 · Reduced service | $251.19 | $281.84 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $112.20 Typical High $169.82 | Professional | 53 · Discontinued | $100.00 | $112.20 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $85.11 Typical High $125.89 | Professional | 55 · Aftercare only | $75.86 | $85.11 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $56.23 Typical High $85.11 | Professional | 56 · Pre-op care only | $50.12 | $56.23 | $85.11 |
Where Iowa sits
The same service costs 2.8 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
$1,175
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.