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 $75.86 Median $5,011.87 Typical High $7,943.28 | Facility | None | $75.86 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $109.65 Typical High $181.97 | Professional | None | $46.77 | $109.65 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $131.83 | Facility | None | $61.66 | $66.07 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $338.84 | Professional | None | $107.15 | $151.36 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $44.67 Median $131.83 Typical High $213.80 | Professional | None | $44.67 | $131.83 | $213.80 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $302.00 Typical High $1,380.38 | Facility | None | $120.23 | $302.00 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $177.83 Typical High $457.09 | Professional | None | $104.71 | $177.83 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $338.84 | Professional | None | $107.15 | $229.09 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $131.83 | Facility | None | $61.66 | $66.07 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $44.67 Median $100.00 Typical High $245.47 | Professional | None | $44.67 | $100.00 | $245.47 |
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 $58.88 Median $128.82 Typical High $288.40 | Professional | None | $58.88 | $128.82 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $234.42 | Professional | None | $81.28 | $89.13 | $234.42 |
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 $23.44 Median $38.02 Typical High $91.20 | Professional | 52 · Reduced service | $23.44 | $38.02 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $15.14 Typical High $37.15 | Professional | 53 · Discontinued | $9.33 | $15.14 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $56.23 Typical High $138.04 | Professional | 54 · Surgery only | $35.48 | $56.23 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $27.54 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $7.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $4.68 | $7.59 | $18.20 |
Where Iowa sits
The same service costs 3.4 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· 7th of 51
$138
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.