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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $346.74 | Professional | None | $131.83 | $173.78 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $309.03 Typical High $309.03 | Facility | None | $141.25 | $309.03 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $398.11 | Professional | None | $302.00 | $363.08 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $338.84 | Professional | None | $257.04 | $275.42 | $338.84 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $302.00 Typical High $1,288.25 | Facility | None | $190.55 | $302.00 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $707.95 | Professional | None | $134.90 | $234.42 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | None | $316.23 | $363.08 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $588.84 | Professional | None | $281.84 | $389.05 | $588.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $776.25 | Facility | None | $398.11 | $398.11 | $776.25 |
United Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $239.88 | Professional | None | $123.03 | $134.90 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $64.57 Median $87.10 Typical High $125.89 | Professional | 52 · Reduced service | $64.57 | $87.10 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $34.67 Typical High $50.12 | Professional | 53 · Discontinued | $25.70 | $34.67 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $26.30 Typical High $38.02 | Professional | 55 · Aftercare only | $19.05 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $17.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $12.88 | $17.38 | $25.12 |
Where Iowa sits
The same service costs 2.2 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· 2nd of 51
$275
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.