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 $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $977.24 | Professional | None | $446.68 | $602.56 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,071.52 | Facility | None | $562.34 | $1,071.52 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,318.26 | Professional | None | $977.24 | $1,258.93 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,096.48 | Professional | None | $741.31 | $954.99 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $4,677.35 | Facility | None | $645.65 | $1,047.13 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $812.83 Typical High $2,511.89 | Professional | None | $457.09 | $812.83 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,318.26 | $1,318.26 |
Midlands Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,584.89 | $1,584.89 |
Oscar Health Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,905.46 | Professional | None | $954.99 | $1,258.93 | $1,905.46 |
United Setting Facility Modifier None Typical Low $660.69 Median $1,412.54 Typical High $2,754.23 | Facility | None | $660.69 | $1,412.54 | $2,754.23 |
United Setting Professional Modifier None Typical Low $436.52 Median $467.74 Typical High $831.76 | Professional | None | $436.52 | $467.74 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $223.87 Median $302.00 Typical High $489.78 | Professional | 52 · Reduced service | $223.87 | $302.00 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $120.23 Typical High $194.98 | Professional | 53 · Discontinued | $89.13 | $120.23 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $147.91 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $60.26 Typical High $97.72 | Professional | 56 · Pre-op care only | $44.67 | $60.26 | $97.72 |
Where Iowa sits
The same service costs 3.6 times more in Hawaii than in Kansas. 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.