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 $26.92 Median $35.48 Typical High $36.31 | Professional | None | $26.92 | $35.48 | $36.31 |
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 $38.02 Typical High $67.61 | Professional | None | $34.67 | $38.02 | $67.61 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $41.69 Typical High $51.29 | Facility | None | $34.67 | $41.69 | $51.29 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $30.90 Typical High $302.00 | Professional | None | $17.78 | $30.90 | $302.00 |
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 $52.48 Typical High $79.43 | Professional | None | $42.66 | $52.48 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $77.62 | Professional | None | $37.15 | $51.29 | $77.62 |
United Setting Professional Modifier None Typical Low $15.14 Median $18.20 Typical High $31.62 | Professional | None | $15.14 | $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 $13.49 Median $17.78 Typical High $18.20 | Professional | 52 · Reduced service | $13.49 | $17.78 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $7.08 Typical High $7.24 | Professional | 53 · Discontinued | $5.37 | $7.08 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $26.30 Typical High $26.92 | Professional | 54 · Surgery only | $19.95 | $26.30 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $3.98 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $3.55 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.69 | $3.55 | $3.63 |
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· 7th of 51
$35.48
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.