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 $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $512.86 | Professional | None | $263.03 | $363.08 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $630.96 Typical High $630.96 | Facility | None | $316.23 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $812.83 | Professional | None | $575.44 | $758.58 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $616.60 | Professional | None | $446.68 | $562.34 | $616.60 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $616.60 Typical High $2,630.27 | Facility | None | $380.19 | $616.60 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $1,479.11 | Professional | None | $275.42 | $478.63 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | None | $660.69 | $758.58 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $933.25 Typical High $933.25 | Professional | None | $575.44 | $933.25 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,230.27 | Professional | None | $575.44 | $794.33 | $1,230.27 |
United Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,584.89 | Facility | None | $831.76 | $831.76 | $1,584.89 |
United Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $489.78 | Professional | None | $251.19 | $281.84 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
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 $131.83 Median $177.83 Typical High $257.04 | Professional | 52 · Reduced service | $131.83 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $72.44 Typical High $102.33 | Professional | 53 · Discontinued | $52.48 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $53.70 Typical High $77.62 | Professional | 55 · Aftercare only | $39.81 | $53.70 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $26.30 | $36.31 | $51.29 |
Where Iowa sits
The same service costs 2.6 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
$562
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.