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 $42.66 Median $85.11 Typical High $85.11 | Facility | None | $42.66 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $85.11 | Professional | None | $31.62 | $42.66 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $75.86 Typical High $75.86 | Facility | None | $45.71 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $112.20 | Professional | None | $74.13 | $97.72 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $56.23 Median $67.61 Typical High $81.28 | Professional | None | $56.23 | $67.61 | $81.28 |
Medica Setting Facility Modifier None Typical Low $45.71 Median $74.13 Typical High $354.81 | Facility | None | $45.71 | $74.13 | $354.81 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $63.10 Typical High $190.55 | Professional | None | $33.11 | $63.10 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $97.72 | Professional | None | $79.43 | $97.72 | $97.72 |
Midlands Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $112.20 | Professional | None | $75.86 | $112.20 | $112.20 |
Oscar Health Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $107.15 Typical High $144.54 | Professional | None | $74.13 | $107.15 | $144.54 |
United Setting Facility Modifier None Typical Low $52.48 Median $107.15 Typical High $208.93 | Facility | None | $52.48 | $107.15 | $208.93 |
United Setting Professional Modifier None Typical Low $32.36 Median $33.11 Typical High $58.88 | Professional | None | $32.36 | $33.11 | $58.88 |
Wellmark Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
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 $15.85 Median $21.38 Typical High $30.90 | Professional | 52 · Reduced service | $15.85 | $21.38 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.51 Typical High $12.30 | Professional | 53 · Discontinued | $6.31 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.46 Typical High $9.33 | Professional | 55 · Aftercare only | $4.68 | $6.46 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.27 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.16 | $4.27 | $6.17 |
Where Iowa sits
The same service costs 3.8 times more in Hawaii than in Florida. 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· 7th of 51
$72.44
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.