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 $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $17.78 Typical High $18.20 | Professional | None | $13.49 | $17.78 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $20.42 Typical High $26.30 | Professional | None | $19.95 | $20.42 | $26.30 |
Hally Health Setting Professional Modifier None Typical Low $17.38 Median $19.05 Typical High $66.07 | Professional | None | $17.38 | $19.05 | $66.07 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $20.42 Typical High $25.70 | Facility | None | $17.38 | $20.42 | $25.70 |
Medica Setting Professional Modifier None Typical Low $8.91 Median $15.49 Typical High $151.36 | Professional | None | $8.91 | $15.49 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | None | $20.42 | $20.42 | $23.99 |
Midlands Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $39.81 | Professional | None | $20.89 | $25.70 | $39.81 |
Oscar Health Setting Professional Modifier None Typical Low $18.20 Median $25.70 Typical High $38.90 | Professional | None | $18.20 | $25.70 | $38.90 |
United Setting Professional Modifier None Typical Low $7.59 Median $8.91 Typical High $15.85 | Professional | None | $7.59 | $8.91 | $15.85 |
Wellmark Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | None | $14.79 | $14.79 | $14.79 |
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 $6.61 Median $8.91 Typical High $9.12 | Professional | 52 · Reduced service | $6.61 | $8.91 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.55 Typical High $3.63 | Professional | 53 · Discontinued | $2.69 | $3.55 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $13.18 Typical High $13.49 | Professional | 54 · Surgery only | $10.00 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.63 Typical High $2.69 | Professional | 55 · Aftercare only | $2.00 | $2.63 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $1.78 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.32 | $1.78 | $1.82 |
Where Iowa sits
The same service costs 2.7 times more in Idaho 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
$17.78
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.