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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $794.33 | Professional | None | $407.38 | $436.52 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $776.25 Typical High $776.25 | Facility | None | $457.09 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,148.15 | Professional | None | $758.58 | $1,023.29 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $1,202.26 | Professional | None | $588.84 | $831.76 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $3,801.89 | Facility | None | $467.74 | $758.58 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $691.83 Typical High $1,995.26 | Professional | None | $338.84 | $691.83 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,023.29 | Professional | None | $794.33 | $1,023.29 | $1,023.29 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,148.15 | Professional | None | $794.33 | $1,148.15 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $1,096.48 Typical High $1,513.56 | Professional | None | $758.58 | $1,096.48 | $1,513.56 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,122.02 Typical High $2,137.96 | Facility | None | $933.25 | $1,122.02 | $2,137.96 |
United Setting Professional Modifier None Typical Low $331.13 Median $338.84 Typical High $630.96 | Professional | None | $331.13 | $338.84 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $204.17 Median $218.78 Typical High $416.87 | Professional | 52 · Reduced service | $204.17 | $218.78 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $165.96 | Professional | 53 · Discontinued | $81.28 | $87.10 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $125.89 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $83.18 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $83.18 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 5th of 51
$759
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.