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 $14.79 Median $14.79 Typical High $14.79 | Facility | None | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $14.79 Typical High $22.91 | Professional | None | $12.30 | $14.79 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $16.98 Typical High $21.88 | Professional | None | $16.60 | $16.98 | $21.88 |
Hally Health Setting Professional Modifier None Typical Low $14.45 Median $16.22 Typical High $41.69 | Professional | None | $14.45 | $16.22 | $41.69 |
Medica Setting Facility Modifier None Typical Low $16.60 Median $19.50 Typical High $38.02 | Facility | None | $16.60 | $19.50 | $38.02 |
Medica Setting Professional Modifier None Typical Low $7.59 Median $12.88 Typical High $295.12 | Professional | None | $7.59 | $12.88 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | None | $16.98 | $16.98 | $19.95 |
Midlands Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $42.66 | Professional | None | $17.78 | $25.70 | $42.66 |
Oscar Health Setting Professional Modifier None Typical Low $15.49 Median $21.88 Typical High $33.11 | Professional | None | $15.49 | $21.88 | $33.11 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $13.18 | Professional | None | $6.46 | $7.59 | $13.18 |
Wellmark Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | None | $12.30 | $12.30 | $12.30 |
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 $6.03 Median $7.41 Typical High $7.59 | Professional | 52 · Reduced service | $6.03 | $7.41 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.95 Typical High $3.02 | Professional | 53 · Discontinued | $2.40 | $2.95 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $11.22 Typical High $11.48 | Professional | 54 · Surgery only | $9.12 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.24 Typical High $2.29 | Professional | 55 · Aftercare only | $1.82 | $2.24 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.48 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.20 | $1.48 | $1.51 |
Where Iowa sits
The same service costs 4.5 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· 7th of 51
$15.14
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.