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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $141.25 Typical High $229.09 | Professional | None | $131.83 | $141.25 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $323.59 | Facility | None | $213.80 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $389.05 | Professional | None | $257.04 | $323.59 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $389.05 | Professional | None | $204.17 | $223.87 | $389.05 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $331.13 Typical High $1,096.48 | Facility | None | $229.09 | $331.13 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $707.95 | Professional | None | $165.96 | $302.00 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | None | $323.59 | $323.59 | $354.81 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $562.34 | Professional | None | $371.54 | $562.34 | $562.34 |
Oscar Health Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $478.63 | Professional | None | $229.09 | $316.23 | $478.63 |
United Setting Facility Modifier None Typical Low $234.42 Median $489.78 Typical High $933.25 | Facility | None | $234.42 | $489.78 | $933.25 |
United Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $295.12 | Professional | None | $158.49 | $165.96 | $295.12 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $66.07 Median $70.79 Typical High $114.82 | Professional | 52 · Reduced service | $66.07 | $70.79 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $28.18 Typical High $45.71 | Professional | 53 · Discontinued | $26.30 | $28.18 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $21.38 Typical High $34.67 | Professional | 55 · Aftercare only | $19.95 | $21.38 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $14.13 Typical High $22.91 | Professional | 56 · Pre-op care only | $13.18 | $14.13 | $22.91 |
Where Iowa sits
The same service costs 2.9 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
$288
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.