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 $52.48 Median $5,011.87 Typical High $7,943.28 | Facility | None | $52.48 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $79.43 Typical High $147.91 | Professional | None | $31.62 | $79.43 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $123.03 | Facility | None | $61.66 | $66.07 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $281.84 | Professional | None | $67.61 | $107.15 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $30.90 Median $97.72 Typical High $162.18 | Professional | None | $30.90 | $97.72 | $162.18 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $245.47 Typical High $1,380.38 | Facility | None | $83.18 | $245.47 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $141.25 Typical High $380.19 | Professional | None | $74.13 | $141.25 | $380.19 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $173.78 Typical High $251.19 | Professional | None | $67.61 | $173.78 | $251.19 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $123.03 | Facility | None | $61.66 | $66.07 | $123.03 |
Oscar Health Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $199.53 | Professional | None | $30.20 | $67.61 | $199.53 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $38.02 Median $87.10 Typical High $234.42 | Professional | None | $38.02 | $87.10 | $234.42 |
Wellmark Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $190.55 | Professional | None | $54.95 | $61.66 | $190.55 |
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 $16.60 Median $26.30 Typical High $74.13 | Professional | 52 · Reduced service | $16.60 | $26.30 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $10.47 Typical High $30.20 | Professional | 53 · Discontinued | $6.61 | $10.47 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $24.55 Median $38.90 Typical High $112.20 | Professional | 54 · Surgery only | $24.55 | $38.90 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $7.76 Typical High $22.39 | Professional | 55 · Aftercare only | $4.90 | $7.76 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $5.25 Typical High $14.79 | Professional | 56 · Pre-op care only | $3.31 | $5.25 | $14.79 |
Where Iowa sits
The same service costs 3.3 times more in Alaska 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
$105
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.