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 $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,047.13 | Professional | None | $537.03 | $676.08 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,202.26 Typical High $1,202.26 | Facility | None | $741.31 | $1,202.26 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,548.82 | $1,659.59 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $1,380.38 | Professional | None | $912.01 | $1,122.02 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,174.90 Typical High $5,495.41 | Facility | None | $724.44 | $1,174.90 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $954.99 Typical High $3,019.95 | Professional | None | $524.81 | $954.99 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,230.27 | $1,548.82 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,778.28 | $1,778.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,513.56 | $2,290.87 |
United Setting Facility Modifier None Typical Low $691.83 Median $1,698.24 Typical High $3,235.94 | Facility | None | $691.83 | $1,698.24 | $3,235.94 |
United Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $933.25 | Professional | None | $501.19 | $524.81 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $269.15 Median $338.84 Typical High $524.81 | Professional | 52 · Reduced service | $269.15 | $338.84 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $134.90 Typical High $208.93 | Professional | 53 · Discontinued | $107.15 | $134.90 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $158.49 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $104.71 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $104.71 |
Where Iowa sits
The same service costs 3.0 times more in Hawaii than in Vermont. 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
$1,148
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.