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 $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $588.84 | Professional | None | $316.23 | $446.68 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $776.25 Typical High $776.25 | Facility | None | $407.38 | $776.25 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,096.48 | Professional | None | $741.31 | $977.24 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $812.83 | Professional | None | $549.54 | $724.44 | $812.83 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $758.58 Typical High $3,548.13 | Facility | None | $467.74 | $758.58 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $1,905.46 | Professional | None | $338.84 | $645.65 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | None | $812.83 | $977.24 | $977.24 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Facility | None | $776.25 | $776.25 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | None | $758.58 | $1,148.15 | $1,148.15 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Professional | None | $758.58 | $1,000.00 | $1,513.56 |
United Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,041.74 | Facility | None | $891.25 | $1,071.52 | $2,041.74 |
United Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $602.56 | Professional | None | $323.59 | $346.74 | $602.56 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $158.49 Median $218.78 Typical High $295.12 | Professional | 52 · Reduced service | $158.49 | $218.78 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $89.13 Typical High $120.23 | Professional | 53 · Discontinued | $63.10 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $66.07 Typical High $89.13 | Professional | 55 · Aftercare only | $47.86 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $44.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $31.62 | $44.67 | $58.88 |
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· 5th of 51
$692
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.