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 $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $22.91 Typical High $23.44 | Professional | None | $17.38 | $22.91 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $26.30 Typical High $33.88 | Professional | None | $25.70 | $26.30 | $33.88 |
Hally Health Setting Professional Modifier None Typical Low $22.39 Median $25.12 Typical High $39.81 | Professional | None | $22.39 | $25.12 | $39.81 |
Medica Setting Facility Modifier None Typical Low $25.70 Median $30.20 Typical High $44.67 | Facility | None | $25.70 | $30.20 | $44.67 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $20.42 Typical High $309.03 | Professional | None | $11.75 | $20.42 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $31.62 | Professional | None | $26.30 | $26.30 | $31.62 |
Midlands Setting Professional Modifier None Typical Low $27.54 Median $39.81 Typical High $51.29 | Professional | None | $27.54 | $39.81 | $51.29 |
Oscar Health Setting Professional Modifier None Typical Low $23.99 Median $33.88 Typical High $51.29 | Professional | None | $23.99 | $33.88 | $51.29 |
United Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $20.42 | Professional | None | $10.00 | $11.75 | $20.42 |
Wellmark Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | None | $19.05 | $19.05 | $19.05 |
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 $8.71 Median $11.48 Typical High $11.75 | Professional | 52 · Reduced service | $8.71 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $3.47 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.18 Median $17.38 Typical High $17.78 | Professional | 54 · Surgery only | $13.18 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.47 Typical High $3.55 | Professional | 55 · Aftercare only | $2.63 | $3.47 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.29 Typical High $2.34 | Professional | 56 · Pre-op care only | $1.74 | $2.29 | $2.34 |
Where Iowa sits
The same service costs 3.2 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
$23.44
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.