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 $38.02 Median $74.13 Typical High $74.13 | Facility | None | $38.02 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $38.02 Typical High $44.67 | Professional | None | $21.88 | $38.02 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $54.95 Typical High $54.95 | Facility | None | $30.20 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $66.07 Typical High $74.13 | Professional | None | $50.12 | $66.07 | $74.13 |
Hally Health Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $58.88 | Professional | None | $46.77 | $51.29 | $58.88 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $53.70 Typical High $229.09 | Facility | None | $33.11 | $53.70 | $229.09 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $41.69 Typical High $125.89 | Professional | None | $23.99 | $41.69 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $66.07 | Professional | None | $56.23 | $66.07 | $66.07 |
Midlands Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $81.28 Typical High $81.28 | Professional | None | $50.12 | $81.28 | $81.28 |
Oscar Health Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $29.51 Median $70.79 Typical High $138.04 | Facility | None | $29.51 | $70.79 | $138.04 |
United Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $42.66 | Professional | None | $22.91 | $24.55 | $42.66 |
Wellmark Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $10.96 Median $19.05 Typical High $22.39 | Professional | 52 · Reduced service | $10.96 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $7.59 Typical High $8.91 | Professional | 53 · Discontinued | $4.37 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $5.62 Typical High $6.61 | Professional | 55 · Aftercare only | $3.31 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $3.80 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.19 | $3.80 | $4.47 |
Where Iowa sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 4th of 51
$48.98
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.