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 $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $32.36 Typical High $33.11 | Professional | None | $18.62 | $32.36 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $47.86 | Professional | None | $36.31 | $37.15 | $47.86 |
Hally Health Setting Professional Modifier None Typical Low $31.62 Median $35.48 Typical High $66.07 | Professional | None | $31.62 | $35.48 | $66.07 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $38.02 Typical High $48.98 | Facility | None | $36.31 | $38.02 | $48.98 |
Medica Setting Professional Modifier None Typical Low $16.22 Median $28.18 Typical High $338.84 | Professional | None | $16.22 | $28.18 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Midlands Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $72.44 | Professional | None | $38.90 | $47.86 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $33.88 Median $47.86 Typical High $72.44 | Professional | None | $33.88 | $47.86 | $72.44 |
United Setting Professional Modifier None Typical Low $14.13 Median $16.60 Typical High $28.84 | Professional | None | $14.13 | $16.60 | $28.84 |
Wellmark Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $12.30 Median $16.22 Typical High $16.60 | Professional | 52 · Reduced service | $12.30 | $16.22 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $6.46 Typical High $6.61 | Professional | 53 · Discontinued | $4.90 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.62 Median $24.55 Typical High $25.12 | Professional | 54 · Surgery only | $18.62 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.90 Typical High $5.01 | Professional | 55 · Aftercare only | $3.72 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $3.24 Typical High $3.31 | Professional | 56 · Pre-op care only | $2.45 | $3.24 | $3.31 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii 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· 7th of 51
$33.11
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.