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 $20.89 Median $20.89 Typical High $117.49 | Facility | None | $20.89 | $20.89 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | None | $20.89 | $20.89 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $35.48 Typical High $63.10 | Professional | None | $20.89 | $35.48 | $63.10 |
Hally Health Setting Professional Modifier None Typical Low $19.05 Median $64.57 Typical High $213.80 | Professional | None | $19.05 | $64.57 | $213.80 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $44.67 Typical High $107.15 | Facility | None | $21.88 | $44.67 | $107.15 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $34.67 Typical High $125.89 | Professional | None | $21.88 | $34.67 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $26.30 Median $35.48 Typical High $72.44 | Professional | None | $26.30 | $35.48 | $72.44 |
Midlands Setting Professional Modifier None Typical Low $23.99 Median $72.44 Typical High $72.44 | Professional | None | $23.99 | $72.44 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $29.51 Median $48.98 Typical High $63.10 | Professional | None | $29.51 | $48.98 | $63.10 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $35.48 | Professional | None | $29.51 | $31.62 | $35.48 |
Wellmark Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Wellmark Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
4 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 $10.47 Median $10.47 Typical High $10.72 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.27 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.14 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.14 |
Where Iowa sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 7th of 51
$29.51
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.