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 $416.87 Median $416.87 Typical High $416.87 | Facility | None | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $416.87 Typical High $676.08 | Professional | None | $407.38 | $416.87 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,000.00 | Facility | None | $630.96 | $1,000.00 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,202.26 | Professional | None | $741.31 | $1,000.00 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,148.15 | Professional | None | $645.65 | $660.69 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $1,122.02 Typical High $3,162.28 | Facility | None | $812.83 | $1,122.02 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $912.01 Typical High $3,311.31 | Professional | None | $537.03 | $912.01 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | None | $1,000.00 | $1,000.00 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,819.70 | $1,819.70 | $3,388.44 |
Oscar Health Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,412.54 | Professional | None | $676.08 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,238.72 | Facility | None | $1,148.15 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $954.99 | Professional | None | $478.63 | $537.03 | $954.99 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $199.53 Median $204.17 Typical High $338.84 | Professional | 52 · Reduced service | $199.53 | $204.17 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $83.18 Typical High $134.90 | Professional | 53 · Discontinued | $81.28 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $61.66 Typical High $100.00 | Professional | 55 · Aftercare only | $60.26 | $61.66 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $41.69 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $41.69 | $67.61 |
Where Iowa sits
The same service costs 2.2 times more in Kansas 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
$891
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.