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 $69.18 Median $5,011.87 Typical High $7,943.28 | Facility | None | $69.18 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $97.72 Typical High $173.78 | Professional | None | $42.66 | $97.72 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $147.91 Typical High $194.98 | Facility | None | $66.07 | $147.91 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $323.59 | Professional | None | $89.13 | $141.25 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $41.69 Median $114.82 Typical High $194.98 | Professional | None | $41.69 | $114.82 | $194.98 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $229.09 Typical High $1,348.96 | Facility | None | $112.20 | $229.09 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $436.52 | Professional | None | $89.13 | $162.18 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $199.53 Typical High $295.12 | Professional | None | $89.13 | $199.53 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $138.04 Typical High $194.98 | Facility | None | $66.07 | $138.04 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $89.13 Typical High $229.09 | Professional | None | $39.81 | $89.13 | $229.09 |
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 $53.70 Median $112.20 Typical High $269.15 | Professional | None | $53.70 | $112.20 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $223.87 | Professional | None | $72.44 | $79.43 | $223.87 |
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 $21.88 Median $34.67 Typical High $87.10 | Professional | 52 · Reduced service | $21.88 | $34.67 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $13.80 Typical High $34.67 | Professional | 53 · Discontinued | $8.71 | $13.80 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $52.48 Typical High $128.82 | Professional | 54 · Surgery only | $33.11 | $52.48 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $10.47 Typical High $25.70 | Professional | 55 · Aftercare only | $6.61 | $10.47 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.92 Typical High $17.38 | Professional | 56 · Pre-op care only | $4.37 | $6.92 | $17.38 |
Where Iowa sits
The same service costs 3.5 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· 7th of 51
$129
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.