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 $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $616.60 | Professional | None | $309.03 | $436.52 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $758.58 Typical High $758.58 | Facility | None | $416.87 | $758.58 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $977.24 | Professional | None | $691.83 | $912.01 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $831.76 | Professional | None | $537.03 | $676.08 | $831.76 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $3,162.28 | Facility | None | $457.09 | $741.31 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $1,737.80 | Professional | None | $331.13 | $575.44 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Facility | None | $758.58 | $758.58 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,122.02 | Professional | None | $691.83 | $1,122.02 | $1,122.02 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $1,479.11 | Professional | None | $691.83 | $954.99 | $1,479.11 |
United Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $1,905.46 | Facility | None | $977.24 | $977.24 | $1,905.46 |
United Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $588.84 | Professional | None | $302.00 | $338.84 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
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 $158.49 Median $213.80 Typical High $309.03 | Professional | 52 · Reduced service | $158.49 | $213.80 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $123.03 | Professional | 53 · Discontinued | $63.10 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $64.57 Typical High $93.33 | Professional | 55 · Aftercare only | $47.86 | $64.57 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $43.65 Typical High $61.66 | Professional | 56 · Pre-op care only | $31.62 | $43.65 | $61.66 |
Where Iowa sits
The same service costs 2.2 times more in Montana 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· 2nd of 51
$676
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.