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 $354.81 Median $2,630.27 Typical High $6,760.83 | Facility | None | $354.81 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $199.53 Typical High $354.81 | Professional | None | $67.61 | $199.53 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $478.63 Typical High $645.65 | Professional | None | $162.18 | $478.63 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $309.03 Typical High $416.87 | Professional | None | $93.33 | $309.03 | $416.87 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $501.19 Typical High $1,513.56 | Facility | None | $158.49 | $501.19 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $575.44 Typical High $1,047.13 | Professional | None | $177.83 | $575.44 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $524.81 Typical High $616.60 | Professional | None | $162.18 | $524.81 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $794.33 | Professional | None | $213.80 | $245.47 | $794.33 |
Oscar Health Setting Professional Modifier None Typical Low $74.13 Median $169.82 Typical High $489.78 | Professional | None | $74.13 | $169.82 | $489.78 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $741.31 | Professional | None | $97.72 | $269.15 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $512.86 | Professional | None | $123.03 | $144.54 | $512.86 |
5 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 $33.88 Median $61.66 Typical High $177.83 | Professional | 52 · Reduced service | $33.88 | $61.66 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $25.12 Typical High $70.79 | Professional | 53 · Discontinued | $13.49 | $25.12 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $93.33 Typical High $269.15 | Professional | 54 · Surgery only | $51.29 | $93.33 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $18.62 Typical High $53.70 | Professional | 55 · Aftercare only | $10.00 | $18.62 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.59 Typical High $35.48 | Professional | 56 · Pre-op care only | $6.76 | $12.59 | $35.48 |
Where Iowa sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 3rd of 51
$407
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.