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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $190.55 | Professional | None | $95.50 | $123.03 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $218.78 Typical High $218.78 | Facility | None | $107.15 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $295.12 | Professional | None | $213.80 | $269.15 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | None | $190.55 | $204.17 | $223.87 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $213.80 Typical High $933.25 | Facility | None | $138.04 | $213.80 | $933.25 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $524.81 | Professional | None | $97.72 | $165.96 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | None | $229.09 | $269.15 | $269.15 |
Midlands Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $426.58 | Professional | None | $204.17 | $275.42 | $426.58 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $562.34 | Facility | None | $295.12 | $295.12 | $562.34 |
United Setting Professional Modifier None Typical Low $89.13 Median $97.72 Typical High $169.82 | Professional | None | $89.13 | $97.72 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $46.77 Median $61.66 Typical High $93.33 | Professional | 52 · Reduced service | $46.77 | $61.66 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $37.15 | Professional | 53 · Discontinued | $19.05 | $24.55 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $27.54 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.30 Typical High $18.62 | Professional | 56 · Pre-op care only | $9.33 | $12.30 | $18.62 |
Where Iowa sits
The same service costs 2.1 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· 8th of 51
$186
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.