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 $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $562.34 | Professional | None | $295.12 | $398.11 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $707.95 Typical High $707.95 | Facility | None | $524.81 | $707.95 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,047.13 | Professional | None | $691.83 | $933.25 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $977.24 | Professional | None | $524.81 | $741.31 | $977.24 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $691.83 Typical High $3,388.44 | Facility | None | $426.58 | $691.83 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $1,819.70 | Professional | None | $309.03 | $562.34 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $933.25 | Professional | None | $724.44 | $933.25 | $933.25 |
Midlands Setting Facility Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | None | $724.44 | $1,047.13 | $1,047.13 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $1,000.00 Typical High $1,348.96 | Professional | None | $691.83 | $1,000.00 | $1,348.96 |
United Setting Facility Modifier None Typical Low $416.87 Median $1,023.29 Typical High $1,949.84 | Facility | None | $416.87 | $1,023.29 | $1,949.84 |
United Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $575.44 | Professional | None | $302.00 | $309.03 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $147.91 Median $199.53 Typical High $281.84 | Professional | 52 · Reduced service | $147.91 | $199.53 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $79.43 Typical High $114.82 | Professional | 53 · Discontinued | $58.88 | $79.43 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $60.26 Typical High $85.11 | Professional | 55 · Aftercare only | $44.67 | $60.26 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $39.81 Typical High $56.23 | Professional | 56 · Pre-op care only | $29.51 | $39.81 | $56.23 |
Where Iowa sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 7th of 51
$631
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.