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 $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $24.55 Typical High $25.12 | Professional | None | $18.62 | $24.55 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $28.18 Typical High $36.31 | Professional | None | $27.54 | $28.18 | $36.31 |
Hally Health Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $44.67 | Professional | None | $23.99 | $26.30 | $44.67 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $28.84 Typical High $35.48 | Facility | None | $22.39 | $28.84 | $35.48 |
Medica Setting Professional Modifier None Typical Low $12.30 Median $21.38 Typical High $199.53 | Professional | None | $12.30 | $21.38 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.11 | Professional | None | $28.18 | $28.18 | $33.11 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $36.31 Typical High $54.95 | Professional | None | $28.18 | $36.31 | $54.95 |
Oscar Health Setting Professional Modifier None Typical Low $25.70 Median $35.48 Typical High $53.70 | Professional | None | $25.70 | $35.48 | $53.70 |
United Setting Professional Modifier None Typical Low $10.47 Median $12.59 Typical High $21.88 | Professional | None | $10.47 | $12.59 | $21.88 |
Wellmark Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
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 $9.33 Median $12.30 Typical High $12.59 | Professional | 52 · Reduced service | $9.33 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.90 Typical High $5.01 | Professional | 53 · Discontinued | $3.72 | $4.90 | $5.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $18.20 Typical High $18.62 | Professional | 54 · Surgery only | $13.80 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.63 Typical High $3.72 | Professional | 55 · Aftercare only | $2.75 | $3.63 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.45 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.86 | $2.45 | $2.51 |
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
$24.55
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.