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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $63.10 Typical High $89.13 | Professional | None | $45.71 | $63.10 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $109.65 Typical High $109.65 | Facility | None | $60.26 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $154.88 | Professional | None | $107.15 | $144.54 | $154.88 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $151.36 | Professional | None | $83.18 | $102.33 | $151.36 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $107.15 Typical High $478.63 | Facility | None | $69.18 | $107.15 | $478.63 |
Medica Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $275.42 | Professional | None | $48.98 | $85.11 | $275.42 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $144.54 | Professional | None | $114.82 | $144.54 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $213.80 | Professional | None | $107.15 | $141.25 | $213.80 |
United Setting Facility Modifier None Typical Low $72.44 Median $154.88 Typical High $302.00 | Facility | None | $72.44 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $87.10 | Professional | None | $47.86 | $48.98 | $87.10 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $22.39 Median $31.62 Typical High $44.67 | Professional | 52 · Reduced service | $22.39 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $12.59 Typical High $18.20 | Professional | 53 · Discontinued | $8.91 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $9.33 Typical High $13.49 | Professional | 55 · Aftercare only | $6.61 | $9.33 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $6.31 Typical High $9.12 | Professional | 56 · Pre-op care only | $4.47 | $6.31 | $9.12 |
Where Iowa sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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
$95.50
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.