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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $83.18 Typical High $95.50 | Professional | None | $50.12 | $83.18 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $144.54 Typical High $144.54 | Facility | None | $66.07 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $154.88 Typical High $169.82 | Professional | None | $131.83 | $154.88 | $169.82 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $128.82 Typical High $151.36 | Professional | None | $97.72 | $128.82 | $151.36 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $141.25 Typical High $562.34 | Facility | None | $89.13 | $141.25 | $562.34 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $109.65 Typical High $302.00 | Professional | None | $61.66 | $109.65 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | None | $151.36 | $154.88 | $169.82 |
Midlands Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $218.78 | Professional | None | $120.23 | $218.78 | $218.78 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $251.19 | Professional | None | $128.82 | $169.82 | $251.19 |
United Setting Facility Modifier None Typical Low $69.18 Median $169.82 Typical High $331.13 | Facility | None | $69.18 | $169.82 | $331.13 |
United Setting Professional Modifier None Typical Low $52.48 Median $64.57 Typical High $114.82 | Professional | None | $52.48 | $64.57 | $114.82 |
Wellmark Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $25.12 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $25.12 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $10.00 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.30 Typical High $14.79 | Professional | 55 · Aftercare only | $7.59 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.01 | $8.32 | $10.00 |
Where Iowa sits
The same service costs 3.5 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· 3rd of 51
$126
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.