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 $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | None | $69.18 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $125.89 | Professional | None | $102.33 | $102.33 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $100.00 | Professional | None | $74.13 | $87.10 | $100.00 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $104.71 Typical High $218.78 | Facility | None | $91.20 | $104.71 | $218.78 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $436.52 | Professional | None | $38.90 | $43.65 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $173.78 | Professional | None | $85.11 | $173.78 | $173.78 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $190.55 | Professional | None | $89.13 | $125.89 | $190.55 |
United Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $245.47 | Facility | None | $128.82 | $128.82 | $245.47 |
United Setting Professional Modifier None Typical Low $19.05 Median $43.65 Typical High $45.71 | Professional | None | $19.05 | $43.65 | $45.71 |
Wellmark Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $34.67 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $34.67 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $13.80 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.92 | $7.41 | $7.41 |
Oscar Health Setting Professional Modifier MV Typical Low $39.81 Median $39.81 Typical High $120.23 | Professional | MV | $39.81 | $39.81 | $120.23 |
Oscar Health Setting Professional Modifier SV · Delivered, not used Typical Low $39.81 Median $39.81 Typical High $120.23 | Professional | SV · Delivered, not used | $39.81 | $39.81 | $120.23 |
Where Iowa sits
The same service costs 2.8 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· 17th of 51
$70.79
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.