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 $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $331.13 Typical High $398.11 | Professional | None | $165.96 | $331.13 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $478.63 | Facility | None | $295.12 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $616.60 | Professional | None | $436.52 | $562.34 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $489.78 | Professional | None | $354.81 | $426.58 | $489.78 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $467.74 Typical High $1,995.26 | Facility | None | $295.12 | $467.74 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $1,096.48 | Professional | None | $213.80 | $363.08 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $562.34 Typical High $562.34 | Professional | None | $501.19 | $562.34 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Facility | None | $478.63 | $478.63 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $707.95 | Professional | None | $436.52 | $707.95 | $707.95 |
Oscar Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $229.09 Median $616.60 Typical High $1,202.26 | Facility | None | $229.09 | $616.60 | $1,202.26 |
United Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $380.19 | Professional | None | $199.53 | $213.80 | $380.19 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $85.11 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $85.11 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $34.67 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $25.70 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $16.98 | $33.11 | $33.11 |
Where Iowa sits
The same service costs 2.5 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
$427
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.