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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $229.09 | Professional | None | $117.49 | $223.87 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $323.59 Typical High $323.59 | Facility | None | $107.15 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $398.11 | Professional | None | $295.12 | $363.08 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $331.13 | Professional | None | $234.42 | $275.42 | $331.13 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $316.23 Typical High $1,258.93 | Facility | None | $194.98 | $316.23 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $691.83 | Professional | None | $141.25 | $245.47 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $380.19 | Professional | None | $331.13 | $363.08 | $380.19 |
Midlands Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | None | $275.42 | $478.63 | $478.63 |
Oscar Health Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $125.89 Median $389.05 Typical High $758.58 | Facility | None | $125.89 | $389.05 | $758.58 |
United Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $251.19 | Professional | None | $134.90 | $144.54 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $60.26 Median $112.20 Typical High $114.82 | Professional | 52 · Reduced service | $60.26 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $44.67 Typical High $45.71 | Professional | 53 · Discontinued | $23.99 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $33.11 Typical High $34.67 | Professional | 55 · Aftercare only | $17.78 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $22.39 Typical High $22.91 | Professional | 56 · Pre-op care only | $12.02 | $22.39 | $22.91 |
Where Iowa sits
The same service costs 2.7 times more in Kansas 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
$288
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.