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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $57.54 Typical High $85.11 | Professional | None | $43.65 | $57.54 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $100.00 Typical High $100.00 | Facility | None | $56.23 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $134.90 | Professional | None | $91.20 | $123.03 | $134.90 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $138.04 | Professional | None | $75.86 | $93.33 | $138.04 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $97.72 Typical High $436.52 | Facility | None | $61.66 | $97.72 | $436.52 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $239.88 | Professional | None | $44.67 | $77.62 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | None | $104.71 | $123.03 | $123.03 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $147.91 | Professional | None | $95.50 | $147.91 | $147.91 |
Oscar Health Setting Professional Modifier None Typical Low $95.50 Median $131.83 Typical High $194.98 | Professional | None | $95.50 | $131.83 | $194.98 |
United Setting Facility Modifier None Typical Low $112.20 Median $134.90 Typical High $263.03 | Facility | None | $112.20 | $134.90 | $263.03 |
United Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $79.43 | Professional | None | $41.69 | $44.67 | $79.43 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $28.84 Typical High $42.66 | Professional | 52 · Reduced service | $21.88 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $11.48 Typical High $16.98 | Professional | 53 · Discontinued | $8.71 | $11.48 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $8.51 Typical High $12.88 | Professional | 55 · Aftercare only | $6.46 | $8.51 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.75 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.37 | $5.75 | $8.51 |
Where Iowa sits
The same service costs 2.6 times more in Kansas than in Arizona. 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
$89.13
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.