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 $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $35.48 Typical High $66.07 | Professional | None | $29.51 | $35.48 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $40.74 Typical High $52.48 | Professional | None | $39.81 | $40.74 | $52.48 |
Hally Health Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $67.61 | Professional | None | $34.67 | $38.90 | $67.61 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $46.77 Typical High $67.61 | Facility | None | $39.81 | $46.77 | $67.61 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $30.90 Typical High $457.09 | Professional | None | $18.20 | $30.90 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None | $40.74 | $40.74 | $47.86 |
Midlands Setting Professional Modifier None Typical Low $42.66 Median $61.66 Typical High $79.43 | Professional | None | $42.66 | $61.66 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $52.48 Typical High $79.43 | Professional | None | $37.15 | $52.48 | $79.43 |
United Setting Professional Modifier None Typical Low $15.49 Median $18.20 Typical High $31.62 | Professional | None | $15.49 | $18.20 | $31.62 |
Wellmark Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
5 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 $14.45 Median $17.78 Typical High $18.20 | Professional | 52 · Reduced service | $14.45 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.08 Typical High $7.24 | Professional | 53 · Discontinued | $5.75 | $7.08 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $26.92 Typical High $27.54 | Professional | 54 · Surgery only | $21.88 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.37 Typical High $5.50 | Professional | 55 · Aftercare only | $4.37 | $5.37 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.55 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.88 | $3.55 | $3.63 |
Where Iowa sits
The same service costs 3.1 times more in Rhode Island than in New York. 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
$36.31
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.