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 $4.17 Median $2,290.87 Typical High $6,760.83 | Facility | None | $4.17 | $2,290.87 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $5.89 Typical High $11.75 | Professional | None | $2.04 | $5.89 | $11.75 |
Cigna Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $8.32 | Facility | None | $7.76 | $7.76 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $4.79 Median $7.41 Typical High $17.78 | Professional | None | $4.79 | $7.41 | $17.78 |
Hally Health Setting Professional Modifier None Typical Low $1.86 Median $8.51 Typical High $16.60 | Professional | None | $1.86 | $8.51 | $16.60 |
Medica Setting Facility Modifier None Typical Low $5.37 Median $16.98 Typical High $1,380.38 | Facility | None | $5.37 | $16.98 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $4.90 Median $13.80 Typical High $67.61 | Professional | None | $4.90 | $13.80 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $4.79 Median $12.02 Typical High $16.98 | Professional | None | $4.79 | $12.02 | $16.98 |
Midlands Setting Facility Modifier None Typical Low $7.76 Median $8.32 Typical High $9.12 | Facility | None | $7.76 | $8.32 | $9.12 |
Oscar Health Setting Professional Modifier None Typical Low $1.82 Median $6.46 Typical High $13.18 | Professional | None | $1.82 | $6.46 | $13.18 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $2.51 Median $6.92 Typical High $17.38 | Professional | None | $2.51 | $6.92 | $17.38 |
Wellmark Setting Professional Modifier None Typical Low $3.31 Median $3.72 Typical High $12.59 | Professional | None | $3.31 | $3.72 | $12.59 |
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 $1.02 Median $1.58 Typical High $5.13 | Professional | 52 · Reduced service | $1.02 | $1.58 | $5.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.41 Median $0.65 Typical High $2.04 | Professional | 53 · Discontinued | $0.41 | $0.65 | $2.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.51 Median $2.40 Typical High $7.59 | Professional | 54 · Surgery only | $1.51 | $2.40 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.48 Typical High $1.51 | Professional | 55 · Aftercare only | $0.30 | $0.48 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.32 Typical High $1.02 | Professional | 56 · Pre-op care only | $0.20 | $0.32 | $1.02 |
Where Iowa sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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
$9.55
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.