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 $109.65 Median $5,011.87 Typical High $7,943.28 | Facility | None | $109.65 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $229.09 | Professional | None | $67.61 | $131.83 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $416.87 | Professional | None | $158.49 | $223.87 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $66.07 Median $177.83 Typical High $263.03 | Professional | None | $66.07 | $177.83 | $263.03 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $371.54 Typical High $1,380.38 | Facility | None | $158.49 | $371.54 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $575.44 | Professional | None | $134.90 | $234.42 | $575.44 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $416.87 | Professional | None | $158.49 | $288.40 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $309.03 | Professional | None | $63.10 | $138.04 | $309.03 |
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 $83.18 Median $173.78 Typical High $363.08 | Professional | None | $83.18 | $173.78 | $363.08 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $295.12 | Professional | None | $114.82 | $128.82 | $295.12 |
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 $34.67 Median $54.95 Typical High $114.82 | Professional | 52 · Reduced service | $34.67 | $54.95 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.88 Typical High $45.71 | Professional | 53 · Discontinued | $13.80 | $21.88 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $83.18 Typical High $173.78 | Professional | 54 · Surgery only | $51.29 | $83.18 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.60 Typical High $34.67 | Professional | 55 · Aftercare only | $10.23 | $16.60 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.96 Typical High $22.91 | Professional | 56 · Pre-op care only | $6.92 | $10.96 | $22.91 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 7th of 51
$191
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.