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 $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $42.66 | Professional | None | $30.90 | $41.69 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $61.66 | Professional | None | $46.77 | $47.86 | $61.66 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $77.62 | Professional | None | $40.74 | $44.67 | $77.62 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $48.98 Typical High $61.66 | Facility | None | $46.77 | $48.98 | $61.66 |
Medica Setting Professional Modifier None Typical Low $20.89 Median $36.31 Typical High $416.87 | Professional | None | $20.89 | $36.31 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | None | $47.86 | $47.86 | $56.23 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $61.66 Typical High $93.33 | Professional | None | $50.12 | $61.66 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $93.33 | Professional | None | $43.65 | $60.26 | $93.33 |
United Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $37.15 | Professional | None | $18.20 | $21.38 | $37.15 |
Wellmark Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $15.85 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $15.85 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $8.32 Typical High $8.51 | Professional | 53 · Discontinued | $6.31 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.44 Median $31.62 Typical High $31.62 | Professional | 54 · Surgery only | $23.44 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.31 Typical High $6.46 | Professional | 55 · Aftercare only | $4.68 | $6.31 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.16 | $4.17 | $4.27 |
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
$42.66
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.