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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $69.18 | Professional | None | $64.57 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $9.55 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $104.71 Typical High $131.83 | Professional | None | $93.33 | $104.71 | $131.83 |
Hally Health Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $117.49 | Professional | None | $72.44 | $79.43 | $117.49 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $89.13 Typical High $194.98 | Facility | None | $53.70 | $89.13 | $194.98 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $489.78 | Professional | None | $36.31 | $39.81 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $158.49 Typical High $158.49 | Professional | None | $83.18 | $158.49 | $158.49 |
Oscar Health Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $173.78 | Professional | None | $87.10 | $128.82 | $173.78 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $234.42 | Facility | None | $123.03 | $123.03 | $234.42 |
United Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $44.67 | Professional | None | $36.31 | $39.81 | $44.67 |
Wellmark Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
3 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 |
|---|---|---|---|---|---|
Oscar Health Setting Professional Modifier DS · Ambulance D to S Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | DS · Ambulance D to S | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier FS · Shared visit Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | FS · Shared visit | $15.14 | $15.14 | $15.14 |
Oscar Health Setting Professional Modifier PR · Ambulance P to R Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | PR · Ambulance P to R | $15.14 | $15.14 | $15.14 |
Where Iowa sits
The same service costs 3.6 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· 21st of 51
$67.61
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.