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 $53.70 Median $2,630.27 Typical High $6,760.83 | Facility | None | $53.70 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $63.10 Typical High $123.03 | Professional | None | $21.88 | $63.10 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $66.07 | Facility | None | $61.66 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $229.09 | Professional | None | $43.65 | $79.43 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $20.89 Median $79.43 Typical High $134.90 | Professional | None | $20.89 | $79.43 | $134.90 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $162.18 Typical High $1,288.25 | Facility | None | $54.95 | $162.18 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $104.71 Typical High $309.03 | Professional | None | $51.29 | $104.71 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $43.65 Median $141.25 Typical High $208.93 | Professional | None | $43.65 | $141.25 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $21.38 Median $47.86 Typical High $165.96 | Professional | None | $21.38 | $47.86 | $165.96 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $27.54 Median $69.18 Typical High $173.78 | Professional | None | $27.54 | $69.18 | $173.78 |
Wellmark Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $162.18 | Professional | None | $38.90 | $43.65 | $162.18 |
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 $10.72 Median $17.38 Typical High $61.66 | Professional | 52 · Reduced service | $10.72 | $17.38 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $6.92 Typical High $24.55 | Professional | 53 · Discontinued | $4.27 | $6.92 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $25.70 Typical High $93.33 | Professional | 54 · Surgery only | $15.85 | $25.70 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $5.13 Typical High $18.62 | Professional | 55 · Aftercare only | $3.24 | $5.13 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $3.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $2.14 | $3.47 | $12.30 |
Where Iowa sits
The same service costs 3.4 times more in Wisconsin than in Kentucky. 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· 11th of 51
$83.18
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.