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 $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $309.03 | Professional | None | $162.18 | $204.17 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $354.81 | Facility | None | $190.55 | $354.81 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $457.09 Typical High $501.19 | Professional | None | $331.13 | $457.09 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $371.54 | Professional | None | $269.15 | $316.23 | $371.54 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $346.74 Typical High $1,584.89 | Facility | None | $218.78 | $346.74 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $891.25 | Professional | None | $154.88 | $288.40 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | None | $371.54 | $457.09 | $457.09 |
Midlands Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | None | $346.74 | $524.81 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $691.83 | Professional | None | $346.74 | $457.09 | $691.83 |
United Setting Facility Modifier None Typical Low $173.78 Median $501.19 Typical High $954.99 | Facility | None | $173.78 | $501.19 | $954.99 |
United Setting Professional Modifier None Typical Low $147.91 Median $158.49 Typical High $281.84 | Professional | None | $147.91 | $158.49 | $281.84 |
Wellmark Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
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 $81.28 Median $102.33 Typical High $154.88 | Professional | 52 · Reduced service | $81.28 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $40.74 Typical High $61.66 | Professional | 53 · Discontinued | $32.36 | $40.74 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.20 Typical High $46.77 | Professional | 55 · Aftercare only | $24.55 | $30.20 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.42 Typical High $30.90 | Professional | 56 · Pre-op care only | $16.22 | $20.42 | $30.90 |
Where Iowa sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 10th of 51
$316
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.