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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $72.44 Typical High $128.82 | Professional | None | $63.10 | $72.44 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $125.89 | Facility | None | $85.11 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $177.83 | Professional | None | $120.23 | $165.96 | $177.83 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $147.91 | Professional | None | $97.72 | $123.03 | $147.91 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $588.84 | Facility | None | $77.62 | $123.03 | $588.84 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $102.33 Typical High $323.59 | Professional | None | $56.23 | $102.33 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | None | $131.83 | $165.96 | $165.96 |
Midlands Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $190.55 | Professional | None | $128.82 | $190.55 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $165.96 Typical High $245.47 | Professional | None | $123.03 | $165.96 | $245.47 |
United Setting Facility Modifier None Typical Low $75.86 Median $181.97 Typical High $346.74 | Facility | None | $75.86 | $181.97 | $346.74 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $100.00 | Professional | None | $53.70 | $56.23 | $100.00 |
Wellmark Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $31.62 Median $36.31 Typical High $66.07 | Professional | 52 · Reduced service | $31.62 | $36.31 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $14.45 Typical High $26.92 | Professional | 53 · Discontinued | $12.88 | $14.45 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.72 Typical High $19.95 | Professional | 55 · Aftercare only | $9.55 | $10.72 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.24 Typical High $13.49 | Professional | 56 · Pre-op care only | $6.31 | $7.24 | $13.49 |
Where Iowa sits
The same service costs 2.8 times more in Hawaii than in Washington, DC. 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
$123
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.