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 $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.98 Typical High $16.98 | Professional | None | $16.22 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.13 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.13 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.39 Typical High $3.39 | Professional | 53 · Discontinued | $3.24 | $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 $1.62 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.62 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $28.84 | Professional | None | $23.44 | $23.44 | $28.84 |
Hally Health Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $21.88 | Professional | None | $14.79 | $19.95 | $21.88 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $26.30 Typical High $56.23 | Facility | None | $21.88 | $26.30 | $56.23 |
Medica Setting Professional Modifier None Typical Low $9.12 Median $10.00 Typical High $131.83 | Professional | None | $9.12 | $10.00 | $131.83 |
Midlands Setting Professional Modifier None Typical Low $20.89 Median $39.81 Typical High $39.81 | Professional | None | $20.89 | $39.81 | $39.81 |
Oscar Health Setting Professional Modifier None Typical Low $20.42 Median $28.84 Typical High $43.65 | Professional | None | $20.42 | $28.84 | $43.65 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $63.10 | Facility | None | $32.36 | $32.36 | $63.10 |
United Setting Professional Modifier None Typical Low $6.03 Median $10.00 Typical High $12.02 | Professional | None | $6.03 | $10.00 | $12.02 |
Wellmark Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
1 more rate 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 BS Typical Low $7.08 Median $7.08 Typical High $15.14 | Professional | BS | $7.08 | $7.08 | $15.14 |
Where Iowa sits
The same service costs 3.2 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· 23rd 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.