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 $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $144.54 | Professional | None | $70.79 | $87.10 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $151.36 | Facility | None | $81.28 | $151.36 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $204.17 | Professional | None | $138.04 | $194.98 | $204.17 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $165.96 | Professional | None | $107.15 | $151.36 | $165.96 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $147.91 Typical High $724.44 | Facility | None | $93.33 | $147.91 | $724.44 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $389.05 | Professional | None | $67.61 | $120.23 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | None | $158.49 | $204.17 | $204.17 |
Midlands Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $229.09 | Professional | None | $154.88 | $229.09 | $229.09 |
Oscar Health Setting Professional Modifier None Typical Low $138.04 Median $194.98 Typical High $295.12 | Professional | None | $138.04 | $194.98 | $295.12 |
United Setting Facility Modifier None Typical Low $120.23 Median $218.78 Typical High $426.58 | Facility | None | $120.23 | $218.78 | $426.58 |
United Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $120.23 | Professional | None | $64.57 | $67.61 | $120.23 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $34.67 Median $43.65 Typical High $70.79 | Professional | 52 · Reduced service | $34.67 | $43.65 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $17.38 Typical High $28.18 | Professional | 53 · Discontinued | $13.80 | $17.38 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.88 Typical High $20.89 | Professional | 55 · Aftercare only | $10.47 | $12.88 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $8.71 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.92 | $8.71 | $14.13 |
Where Iowa sits
The same service costs 5.0 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· 8th of 51
$135
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.