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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $776.25 | Professional | None | $407.38 | $549.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $954.99 Typical High $954.99 | Facility | None | $501.19 | $954.99 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,348.96 | Professional | None | $891.25 | $1,202.26 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $1,000.00 | Professional | None | $676.08 | $851.14 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $4,265.80 | Facility | None | $575.44 | $933.25 | $4,265.80 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $741.31 Typical High $2,344.23 | Professional | None | $416.87 | $741.31 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,202.26 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,412.54 | Professional | None | $912.01 | $1,412.54 | $1,412.54 |
Oscar Health Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,862.09 | Professional | None | $933.25 | $1,230.27 | $1,862.09 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,318.26 Typical High $2,511.89 | Facility | None | $562.34 | $1,318.26 | $2,511.89 |
United Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $741.31 | Professional | None | $398.11 | $426.58 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
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 $204.17 Median $269.15 Typical High $389.05 | Professional | 52 · Reduced service | $204.17 | $269.15 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $158.49 | Professional | 53 · Discontinued | $81.28 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $81.28 Typical High $117.49 | Professional | 55 · Aftercare only | $61.66 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $77.62 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $77.62 |
Where Iowa sits
The same service costs 3.9 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
$851
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.