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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $74.13 | Professional | None | $54.95 | $72.44 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $107.15 | Professional | None | $81.28 | $83.18 | $107.15 |
Hally Health Setting Professional Modifier None Typical Low $70.79 Median $75.86 Typical High $91.20 | Professional | None | $70.79 | $75.86 | $91.20 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $85.11 Typical High $104.71 | Facility | None | $74.13 | $85.11 | $104.71 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $63.10 Typical High $645.65 | Professional | None | $36.31 | $63.10 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | None | $83.18 | $83.18 | $97.72 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $162.18 | Professional | None | $87.10 | $107.15 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $158.49 | Professional | None | $75.86 | $104.71 | $158.49 |
United Setting Professional Modifier None Typical Low $31.62 Median $37.15 Typical High $64.57 | Professional | None | $31.62 | $37.15 | $64.57 |
Wellmark Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $27.54 Median $36.31 Typical High $37.15 | Professional | 52 · Reduced service | $27.54 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $14.45 Typical High $14.79 | Professional | 53 · Discontinued | $10.96 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $53.70 Typical High $54.95 | Professional | 54 · Surgery only | $40.74 | $53.70 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $8.13 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $7.24 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.50 | $7.24 | $7.41 |
Where Iowa sits
The same service costs 2.8 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· 6th of 51
$74.13
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.