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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $85.11 | Professional | None | $43.65 | $70.79 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $125.89 Typical High $125.89 | Facility | None | $53.70 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $147.91 | Professional | None | $117.49 | $128.82 | $147.91 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $204.17 | Professional | None | $85.11 | $112.20 | $204.17 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $457.09 | Facility | None | $77.62 | $123.03 | $457.09 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $251.19 | Professional | None | $51.29 | $95.50 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | None | $128.82 | $128.82 | $147.91 |
Midlands Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $218.78 | Professional | None | $109.65 | $147.91 | $218.78 |
United Setting Facility Modifier None Typical Low $39.81 Median $141.25 Typical High $269.15 | Facility | None | $39.81 | $141.25 | $269.15 |
United Setting Professional Modifier None Typical Low $42.66 Median $54.95 Typical High $97.72 | Professional | None | $42.66 | $54.95 | $97.72 |
Wellmark Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $21.88 Median $35.48 Typical High $43.65 | Professional | 52 · Reduced service | $21.88 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $14.13 Typical High $17.38 | Professional | 53 · Discontinued | $8.71 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $6.61 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $4.37 | $7.08 | $8.71 |
Where Iowa sits
The same service costs 3.3 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
$107
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.