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 $64.57 Median $125.89 Typical High $125.89 | Facility | None | $64.57 | $125.89 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $64.57 Typical High $112.20 | Professional | None | $53.70 | $64.57 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $112.20 Typical High $112.20 | Facility | None | $67.61 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $169.82 | Professional | None | $109.65 | $151.36 | $169.82 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $117.49 | Professional | None | $85.11 | $109.65 | $117.49 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $109.65 Typical High $537.03 | Facility | None | $69.18 | $109.65 | $537.03 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $295.12 | Professional | None | $50.12 | $95.50 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | None | $117.49 | $151.36 | $151.36 |
Midlands Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Facility | None | $112.20 | $112.20 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $169.82 | Professional | None | $114.82 | $169.82 | $169.82 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $218.78 | Professional | None | $112.20 | $154.88 | $218.78 |
United Setting Facility Modifier None Typical Low $77.62 Median $165.96 Typical High $316.23 | Facility | None | $77.62 | $165.96 | $316.23 |
United Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $89.13 | Professional | None | $48.98 | $50.12 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $26.92 Median $32.36 Typical High $53.70 | Professional | 52 · Reduced service | $26.92 | $32.36 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.88 Typical High $21.38 | Professional | 53 · Discontinued | $10.96 | $12.88 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.77 Typical High $16.22 | Professional | 55 · Aftercare only | $8.13 | $9.77 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.46 Typical High $10.72 | Professional | 56 · Pre-op care only | $5.37 | $6.46 | $10.72 |
Where Iowa sits
The same service costs 4.1 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· 6th of 51
$100
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.