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 $147.91 Median $5,011.87 Typical High $7,943.28 | Facility | None | $147.91 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $151.36 Typical High $275.42 | Professional | None | $89.13 | $151.36 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $204.17 Typical High $275.42 | Facility | None | $114.82 | $204.17 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $501.19 | Professional | None | $213.80 | $295.12 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $87.10 Median $213.80 Typical High $316.23 | Professional | None | $87.10 | $213.80 | $316.23 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $389.05 Typical High $1,288.25 | Facility | None | $194.98 | $389.05 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $707.95 | Professional | None | $169.82 | $281.84 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | None | $213.80 | $338.84 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $190.55 Typical High $275.42 | Facility | None | $114.82 | $190.55 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $85.11 Median $177.83 Typical High $371.54 | Professional | None | $85.11 | $177.83 | $371.54 |
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 $114.82 Median $208.93 Typical High $436.52 | Professional | None | $114.82 | $208.93 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $354.81 | Professional | None | $154.88 | $169.82 | $354.81 |
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 $46.77 Median $74.13 Typical High $138.04 | Professional | 52 · Reduced service | $46.77 | $74.13 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $29.51 Typical High $54.95 | Professional | 53 · Discontinued | $18.62 | $29.51 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $109.65 Typical High $204.17 | Professional | 54 · Surgery only | $69.18 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.88 Typical High $40.74 | Professional | 55 · Aftercare only | $13.80 | $21.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.79 Typical High $27.54 | Professional | 56 · Pre-op care only | $9.33 | $14.79 | $27.54 |
Where Iowa sits
The same service costs 3.3 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· 6th of 51
$240
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.