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 $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $95.50 | Professional | None | $43.65 | $60.26 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $107.15 Typical High $107.15 | Facility | None | $57.54 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $134.90 | Professional | None | $100.00 | $128.82 | $134.90 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $112.20 | Professional | None | $75.86 | $95.50 | $112.20 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $104.71 Typical High $467.74 | Facility | None | $64.57 | $104.71 | $467.74 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $263.03 | Professional | None | $46.77 | $87.10 | $263.03 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | None | $112.20 | $134.90 | $134.90 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $158.49 | Professional | None | $102.33 | $158.49 | $158.49 |
Oscar Health Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $194.98 | Professional | None | $97.72 | $128.82 | $194.98 |
United Setting Facility Modifier None Typical Low $51.29 Median $147.91 Typical High $281.84 | Facility | None | $51.29 | $147.91 | $281.84 |
United Setting Professional Modifier None Typical Low $44.67 Median $47.86 Typical High $83.18 | Professional | None | $44.67 | $47.86 | $83.18 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $21.88 Median $30.20 Typical High $43.65 | Professional | 52 · Reduced service | $21.88 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.02 Typical High $17.38 | Professional | 53 · Discontinued | $8.71 | $12.02 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.12 Typical High $13.18 | Professional | 55 · Aftercare only | $6.61 | $9.12 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.03 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.37 | $6.03 | $8.71 |
Where Iowa sits
The same service costs 2.6 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· 6th of 51
$95.50
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.