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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $41.69 | Professional | None | $28.84 | $40.74 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $46.77 Typical High $60.26 | Professional | None | $45.71 | $46.77 | $60.26 |
Hally Health Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $77.62 | Professional | None | $39.81 | $44.67 | $77.62 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $47.86 Typical High $58.88 | Facility | None | $30.90 | $47.86 | $58.88 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $35.48 Typical High $269.15 | Professional | None | $20.89 | $35.48 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | None | $46.77 | $46.77 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $91.20 | Professional | None | $38.90 | $60.26 | $91.20 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $91.20 | Professional | None | $42.66 | $60.26 | $91.20 |
United Setting Professional Modifier None Typical Low $17.78 Median $20.89 Typical High $36.31 | Professional | None | $17.78 | $20.89 | $36.31 |
Wellmark Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $15.49 Median $20.42 Typical High $20.89 | Professional | 52 · Reduced service | $15.49 | $20.42 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $8.13 Typical High $8.32 | Professional | 53 · Discontinued | $6.17 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $30.90 Typical High $31.62 | Professional | 54 · Surgery only | $23.44 | $30.90 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.17 Typical High $6.31 | Professional | 55 · Aftercare only | $4.68 | $6.17 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $4.07 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.09 | $4.07 | $4.17 |
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
$40.74
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.