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 $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $251.19 | Professional | None | $125.89 | $199.53 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $346.74 | Facility | None | $177.83 | $346.74 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $398.11 Typical High $436.52 | Professional | None | $323.59 | $398.11 | $436.52 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $363.08 | Professional | None | $251.19 | $302.00 | $363.08 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $338.84 Typical High $1,412.54 | Facility | None | $213.80 | $338.84 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $269.15 Typical High $776.25 | Professional | None | $151.36 | $269.15 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $416.87 | Professional | None | $363.08 | $398.11 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $524.81 | Professional | None | $309.03 | $524.81 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $660.69 | Professional | None | $316.23 | $436.52 | $660.69 |
United Setting Facility Modifier None Typical Low $186.21 Median $436.52 Typical High $831.76 | Facility | None | $186.21 | $436.52 | $831.76 |
United Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $275.42 | Professional | None | $131.83 | $154.88 | $275.42 |
Wellmark Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $63.10 Median $100.00 Typical High $125.89 | Professional | 52 · Reduced service | $63.10 | $100.00 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $39.81 Typical High $50.12 | Professional | 53 · Discontinued | $25.12 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $19.05 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.95 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.59 | $19.95 | $25.12 |
Where Iowa sits
The same service costs 3.5 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· 3rd of 51
$309
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.