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 $50.12 Median $50.12 Typical High $77.62 | Facility | None | $50.12 | $50.12 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $50.12 Typical High $70.79 | Professional | None | $37.15 | $50.12 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $74.13 | Professional | None | $56.23 | $57.54 | $74.13 |
Hally Health Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $134.90 | Professional | None | $48.98 | $54.95 | $134.90 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $66.07 Typical High $107.15 | Facility | None | $56.23 | $66.07 | $107.15 |
Medica Setting Professional Modifier None Typical Low $25.70 Median $43.65 Typical High $724.44 | Professional | None | $25.70 | $43.65 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | None | $57.54 | $57.54 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $85.11 Typical High $112.20 | Professional | None | $60.26 | $85.11 | $112.20 |
Oscar Health Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $112.20 | Professional | None | $52.48 | $74.13 | $112.20 |
United Setting Professional Modifier None Typical Low $21.88 Median $25.70 Typical High $44.67 | Professional | None | $21.88 | $25.70 | $44.67 |
Wellmark Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
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 $19.05 Median $25.12 Typical High $25.70 | Professional | 52 · Reduced service | $19.05 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.00 Typical High $10.23 | Professional | 53 · Discontinued | $7.59 | $10.00 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $38.02 Typical High $38.90 | Professional | 54 · Surgery only | $28.84 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.59 Typical High $7.76 | Professional | 55 · Aftercare only | $5.75 | $7.59 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.01 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.80 | $5.01 | $5.13 |
Where Iowa sits
The same service costs 2.6 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
$51.29
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.