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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | None | $60.26 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | None | $89.13 | $89.13 | $112.20 |
Hally Health Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $87.10 | Professional | None | $66.07 | $77.62 | $87.10 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $93.33 Typical High $194.98 | Facility | None | $81.28 | $93.33 | $194.98 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $389.05 | Professional | None | $34.67 | $38.90 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $154.88 Typical High $154.88 | Professional | None | $75.86 | $154.88 | $154.88 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $112.20 Typical High $169.82 | Professional | None | $79.43 | $112.20 | $169.82 |
United Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $218.78 | Facility | None | $112.20 | $112.20 | $218.78 |
United Setting Professional Modifier None Typical Low $19.05 Median $38.90 Typical High $43.65 | Professional | None | $19.05 | $38.90 | $43.65 |
Wellmark Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
6 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 $30.20 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $12.30 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.77 Typical High $9.77 | Professional | 55 · Aftercare only | $9.12 | $9.77 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.61 | $6.61 |
Oscar Health Setting Professional Modifier MV Typical Low $25.12 Median $25.12 Typical High $54.95 | Professional | MV | $25.12 | $25.12 | $54.95 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $25.12 Median $25.12 Typical High $54.95 | Professional | SV · Delivered, not used | $25.12 | $25.12 | $54.95 |
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· 15th of 51
$63.10
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.