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 $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $251.19 Typical High $371.54 | Professional | None | $186.21 | $251.19 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $446.68 Typical High $446.68 | Facility | None | $245.47 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $660.69 | Professional | None | $436.52 | $588.84 | $660.69 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | None | $331.13 | $398.11 | $489.78 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $436.52 Typical High $2,089.30 | Facility | None | $269.15 | $436.52 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $346.74 Typical High $1,148.15 | Professional | None | $194.98 | $346.74 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $588.84 | Professional | None | $457.09 | $588.84 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $660.69 | Professional | None | $457.09 | $660.69 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $891.25 | Professional | None | $436.52 | $660.69 | $891.25 |
United Setting Facility Modifier None Typical Low $204.17 Median $645.65 Typical High $1,230.27 | Facility | None | $204.17 | $645.65 | $1,230.27 |
United Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $346.74 | Professional | None | $190.55 | $194.98 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $93.33 Median $125.89 Typical High $186.21 | Professional | 52 · Reduced service | $93.33 | $125.89 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $50.12 Typical High $74.13 | Professional | 53 · Discontinued | $37.15 | $50.12 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $38.02 Typical High $54.95 | Professional | 55 · Aftercare only | $28.18 | $38.02 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $25.12 Typical High $37.15 | Professional | 56 · Pre-op care only | $18.62 | $25.12 | $37.15 |
Where Iowa sits
The same service costs 2.9 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· 10th of 51
$398
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.