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 $31.62 Median $31.62 Typical High $141.25 | Facility | None | $31.62 | $31.62 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $39.81 | Professional | None | $31.62 | $31.62 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $42.66 Typical High $52.48 | Professional | None | $31.62 | $42.66 | $52.48 |
Hally Health Setting Professional Modifier None Typical Low $40.74 Median $45.71 Typical High $186.21 | Professional | None | $40.74 | $45.71 | $186.21 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $67.61 Typical High $75.86 | Facility | None | $44.67 | $67.61 | $75.86 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $234.42 | Professional | None | $44.67 | $56.23 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $52.48 | Professional | None | $42.66 | $42.66 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $190.55 | Professional | None | $36.31 | $52.48 | $190.55 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $81.28 | Professional | None | $38.90 | $63.10 | $81.28 |
United Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
United Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $42.66 | Professional | None | $35.48 | $37.15 | $42.66 |
Wellmark Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Wellmark Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $15.85 Median $15.85 Typical High $16.22 | Professional | 52 · Reduced service | $15.85 | $15.85 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
Where Iowa sits
The same service costs 1.7 times more in Hawaii 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· 3rd of 51
$48.98
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.