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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $11.48 Typical High $11.75 | Professional | None | $7.94 | $11.48 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $13.18 Typical High $16.98 | Professional | None | $12.88 | $13.18 | $16.98 |
Hally Health Setting Professional Modifier None Typical Low $11.22 Median $12.30 Typical High $31.62 | Professional | None | $11.22 | $12.30 | $31.62 |
Medica Setting Facility Modifier None Typical Low $12.88 Median $15.14 Typical High $19.95 | Facility | None | $12.88 | $15.14 | $19.95 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $10.00 Typical High $138.04 | Professional | None | $5.75 | $10.00 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | None | $13.18 | $13.18 | $15.49 |
Midlands Setting Professional Modifier None Typical Low $13.80 Median $19.50 Typical High $25.70 | Professional | None | $13.80 | $19.50 | $25.70 |
Oscar Health Setting Professional Modifier None Typical Low $12.02 Median $16.60 Typical High $25.12 | Professional | None | $12.02 | $16.60 | $25.12 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.75 Typical High $10.23 | Professional | None | $4.90 | $5.75 | $10.23 |
Wellmark Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $4.37 Median $5.75 Typical High $5.89 | Professional | 52 · Reduced service | $4.37 | $5.75 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $2.29 Typical High $2.34 | Professional | 53 · Discontinued | $1.74 | $2.29 | $2.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.46 Median $8.51 Typical High $8.71 | Professional | 54 · Surgery only | $6.46 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.29 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $1.12 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.85 | $1.12 | $1.17 |
Where Iowa sits
The same service costs 2.9 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· 6th of 51
$11.75
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.