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 $24.55 Median $5,011.87 Typical High $7,943.28 | Facility | None | $24.55 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $24.55 Typical High $28.18 | Professional | None | $15.49 | $24.55 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $13.18 Typical High $14.13 | Facility | None | $13.18 | $13.18 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $50.12 | Professional | None | $35.48 | $40.74 | $50.12 |
Hally Health Setting Professional Modifier None Typical Low $14.79 Median $25.12 Typical High $41.69 | Professional | None | $14.79 | $25.12 | $41.69 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $48.98 Typical High $1,621.81 | Facility | None | $30.90 | $48.98 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $42.66 Typical High $57.54 | Professional | None | $21.88 | $42.66 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $50.12 | Professional | None | $35.48 | $40.74 | $50.12 |
Midlands Setting Facility Modifier None Typical Low $13.18 Median $14.13 Typical High $15.14 | Facility | None | $13.18 | $14.13 | $15.14 |
Oscar Health Setting Professional Modifier None Typical Low $14.45 Median $25.70 Typical High $39.81 | Professional | None | $14.45 | $25.70 | $39.81 |
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 $18.20 Median $26.30 Typical High $51.29 | Professional | None | $18.20 | $26.30 | $51.29 |
Wellmark Setting Professional Modifier None Typical Low $25.70 Median $28.84 Typical High $36.31 | Professional | None | $25.70 | $28.84 | $36.31 |
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 $7.76 Median $12.30 Typical High $14.13 | Professional | 52 · Reduced service | $7.76 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $4.90 Typical High $5.62 | Professional | 53 · Discontinued | $3.09 | $4.90 | $5.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $18.62 Typical High $21.38 | Professional | 54 · Surgery only | $11.75 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.72 Typical High $4.27 | Professional | 55 · Aftercare only | $2.34 | $3.72 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.45 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.55 | $2.45 | $2.82 |
Where Iowa sits
The same service costs 3.9 times more in Alaska than in New Jersey. 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· 6th of 51
$32.36
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.