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 $114.82 Median $5,011.87 Typical High $7,943.28 | Facility | None | $114.82 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $131.83 Typical High $234.42 | Professional | None | $69.18 | $131.83 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $181.97 Typical High $245.47 | Facility | None | $114.82 | $181.97 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $436.52 | Professional | None | $144.54 | $229.09 | $436.52 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $269.15 | Professional | None | $69.18 | $162.18 | $269.15 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $1,288.25 | Facility | None | $158.49 | $302.00 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $588.84 | Professional | None | $131.83 | $229.09 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $389.05 | Professional | None | $144.54 | $263.03 | $389.05 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $245.47 | Facility | None | $114.82 | $173.78 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $66.07 Median $144.54 Typical High $323.59 | Professional | None | $66.07 | $144.54 | $323.59 |
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 $87.10 Median $173.78 Typical High $371.54 | Professional | None | $87.10 | $173.78 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $302.00 | Professional | None | $120.23 | $134.90 | $302.00 |
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 $36.31 Median $57.54 Typical High $117.49 | Professional | 52 · Reduced service | $36.31 | $57.54 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $22.91 Typical High $46.77 | Professional | 53 · Discontinued | $14.45 | $22.91 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $85.11 Typical High $177.83 | Professional | 54 · Surgery only | $53.70 | $85.11 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $16.98 Typical High $35.48 | Professional | 55 · Aftercare only | $10.72 | $16.98 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $11.48 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.24 | $11.48 | $23.44 |
Where Iowa sits
The same service costs 3.2 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
$186
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.