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 $70.79 Median $2,630.27 Typical High $6,760.83 | Facility | None | $70.79 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $45.71 Typical High $91.20 | Professional | None | $23.44 | $45.71 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $44.67 | Facility | None | $41.69 | $41.69 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $123.03 | Professional | None | $52.48 | $74.13 | $123.03 |
Hally Health Setting Professional Modifier None Typical Low $22.39 Median $54.95 Typical High $75.86 | Professional | None | $22.39 | $54.95 | $75.86 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $112.20 Typical High $1,288.25 | Facility | None | $58.88 | $112.20 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $177.83 | Professional | None | $51.29 | $72.44 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $120.23 | Professional | None | $52.48 | $85.11 | $120.23 |
Midlands Setting Facility Modifier None Typical Low $41.69 Median $44.67 Typical High $48.98 | Facility | None | $41.69 | $44.67 | $48.98 |
Oscar Health Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $112.20 Median $575.44 Typical High $1,995.26 | Facility | None | $112.20 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $29.51 Median $53.70 Typical High $107.15 | Professional | None | $29.51 | $53.70 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $89.13 | Professional | None | $42.66 | $46.77 | $89.13 |
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 $11.75 Median $22.91 Typical High $42.66 | Professional | 52 · Reduced service | $11.75 | $22.91 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $9.33 Typical High $17.38 | Professional | 53 · Discontinued | $4.68 | $9.33 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $34.67 Typical High $64.57 | Professional | 54 · Surgery only | $17.78 | $34.67 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $6.92 Typical High $12.88 | Professional | 55 · Aftercare only | $3.55 | $6.92 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $4.57 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.34 | $4.57 | $8.71 |
Where Iowa sits
The same service costs 3.5 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· 5th of 51
$69.18
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.