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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $870.96 | Professional | None | $426.58 | $616.60 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,071.52 Typical High $1,071.52 | Facility | None | $549.54 | $1,071.52 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,258.93 | Professional | None | $977.24 | $1,202.26 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,230.27 | Professional | None | $707.95 | $954.99 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $1,047.13 Typical High $4,265.80 | Facility | None | $660.69 | $1,047.13 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $2,344.23 | Professional | None | $467.74 | $812.83 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,258.93 | Professional | None | $1,122.02 | $1,202.26 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,621.81 Typical High $1,621.81 | Professional | None | $912.01 | $1,621.81 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,819.70 | Professional | None | $912.01 | $1,258.93 | $1,819.70 |
United Setting Facility Modifier None Typical Low $436.52 Median $1,318.26 Typical High $2,511.89 | Facility | None | $436.52 | $1,318.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $851.14 | Professional | None | $398.11 | $478.63 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $213.80 Median $309.03 Typical High $416.87 | Professional | 52 · Reduced service | $213.80 | $309.03 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $123.03 Typical High $169.82 | Professional | 53 · Discontinued | $85.11 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $91.20 Typical High $125.89 | Professional | 55 · Aftercare only | $64.57 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $61.66 Typical High $83.18 | Professional | 56 · Pre-op care only | $42.66 | $61.66 | $83.18 |
Where Iowa sits
The same service costs 2.4 times more in Iowa 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· 1st of 51
$955
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.