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 $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $81.28 Typical High $83.18 | Professional | None | $58.88 | $81.28 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $93.33 Typical High $120.23 | Professional | None | $91.20 | $93.33 | $120.23 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $89.13 Typical High $128.82 | Professional | None | $79.43 | $89.13 | $128.82 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $95.50 Typical High $117.49 | Facility | None | $61.66 | $95.50 | $117.49 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $549.54 | Professional | None | $41.69 | $72.44 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | None | $93.33 | $93.33 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $181.97 | Professional | None | $77.62 | $120.23 | $181.97 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $181.97 | Professional | None | $85.11 | $120.23 | $181.97 |
United Setting Professional Modifier None Typical Low $35.48 Median $41.69 Typical High $72.44 | Professional | None | $35.48 | $41.69 | $72.44 |
Wellmark Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $30.90 Median $40.74 Typical High $41.69 | Professional | 52 · Reduced service | $30.90 | $40.74 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $12.30 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $61.66 Typical High $63.10 | Professional | 54 · Surgery only | $46.77 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.30 Typical High $12.59 | Professional | 55 · Aftercare only | $9.33 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $8.13 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.17 | $8.13 | $8.32 |
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
$81.28
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.