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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $25.12 Typical High $25.70 | Professional | None | $18.62 | $25.12 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $37.15 | Professional | None | $28.18 | $28.84 | $37.15 |
Hally Health Setting Professional Modifier None Typical Low $24.55 Median $27.54 Typical High $61.66 | Professional | None | $24.55 | $27.54 | $61.66 |
Medica Setting Facility Modifier None Typical Low $28.18 Median $33.11 Typical High $53.70 | Facility | None | $28.18 | $33.11 | $53.70 |
Medica Setting Professional Modifier None Typical Low $12.59 Median $21.88 Typical High $363.08 | Professional | None | $12.59 | $21.88 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | None | $28.84 | $28.84 | $33.88 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $56.23 | Professional | None | $30.20 | $42.66 | $56.23 |
Oscar Health Setting Professional Modifier None Typical Low $26.30 Median $36.31 Typical High $56.23 | Professional | None | $26.30 | $36.31 | $56.23 |
United Setting Professional Modifier None Typical Low $10.96 Median $12.88 Typical High $22.39 | Professional | None | $10.96 | $12.88 | $22.39 |
Wellmark Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $9.55 Median $12.59 Typical High $12.88 | Professional | 52 · Reduced service | $9.55 | $12.59 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $5.01 Typical High $5.13 | Professional | 53 · Discontinued | $3.80 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $19.05 Typical High $19.50 | Professional | 54 · Surgery only | $14.13 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.80 Typical High $3.89 | Professional | 55 · Aftercare only | $2.82 | $3.80 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.51 Typical High $2.57 | Professional | 56 · Pre-op care only | $1.91 | $2.51 | $2.57 |
Where Iowa sits
The same service costs 3.5 times more in Rhode Island 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· 8th of 51
$25.12
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.