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 $16.60 Median $16.60 Typical High $16.60 | Facility | None | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | None | $15.85 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $24.55 Typical High $30.90 | Professional | None | $22.91 | $24.55 | $30.90 |
Hally Health Setting Professional Modifier None Typical Low $16.98 Median $19.50 Typical High $79.43 | Professional | None | $16.98 | $19.50 | $79.43 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $26.30 Typical High $54.95 | Facility | None | $21.88 | $26.30 | $54.95 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $9.77 Typical High $123.03 | Professional | None | $9.12 | $9.77 | $123.03 |
Midlands Setting Professional Modifier None Typical Low $19.05 Median $38.90 Typical High $38.90 | Professional | None | $19.05 | $38.90 | $38.90 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $21.88 Typical High $42.66 | Professional | None | $10.00 | $21.88 | $42.66 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $61.66 | Facility | None | $32.36 | $32.36 | $61.66 |
United Setting Professional Modifier None Typical Low $9.12 Median $9.77 Typical High $15.14 | Professional | None | $9.12 | $9.77 | $15.14 |
Wellmark Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
7 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 $7.94 Median $8.32 Typical High $8.32 | Professional | 52 · Reduced service | $7.94 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.16 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.51 Typical High $2.51 | Professional | 55 · Aftercare only | $2.40 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $1.66 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.58 | $1.66 | $1.66 |
Oscar Health Setting Professional Modifier MV Typical Low $25.12 Median $25.12 Typical High $64.57 | Professional | MV | $25.12 | $25.12 | $64.57 |
Oscar Health Setting Professional Modifier SM · Second surgical opinion Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | SM · Second surgical opinion | $10.00 | $10.00 | $10.00 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $25.12 Median $25.12 Typical High $64.57 | Professional | SV · Delivered, not used | $25.12 | $25.12 | $64.57 |
Where Iowa sits
The same service costs 3.0 times more in Montana 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· 25th of 51
$16.22
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.