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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $46.77 Typical High $47.86 | Professional | None | $17.38 | $46.77 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $69.18 | Professional | None | $52.48 | $53.70 | $69.18 |
Hally Health Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $83.18 | Professional | None | $45.71 | $50.12 | $83.18 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $53.70 Typical High $67.61 | Facility | None | $36.31 | $53.70 | $67.61 |
Medica Setting Professional Modifier None Typical Low $23.44 Median $40.74 Typical High $316.23 | Professional | None | $23.44 | $40.74 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $63.10 | Professional | None | $53.70 | $53.70 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $104.71 | Professional | None | $45.71 | $67.61 | $104.71 |
Oscar Health Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $102.33 | Professional | None | $48.98 | $67.61 | $102.33 |
United Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $41.69 | Professional | None | $19.95 | $23.44 | $41.69 |
Wellmark Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
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 $17.38 Median $23.44 Typical High $23.99 | Professional | 52 · Reduced service | $17.38 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.33 Typical High $9.55 | Professional | 53 · Discontinued | $7.08 | $9.33 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $34.67 Typical High $35.48 | Professional | 54 · Surgery only | $26.30 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.92 Typical High $7.08 | Professional | 55 · Aftercare only | $5.25 | $6.92 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.68 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.55 | $4.68 | $4.79 |
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
$46.77
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.