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 $74.13 Median $251.19 Typical High $6,309.57 | Facility | None | $74.13 | $251.19 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $75.86 Typical High $128.82 | Professional | None | $36.31 | $75.86 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $109.65 | Facility | None | $100.00 | $102.33 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $229.09 | Professional | None | $85.11 | $109.65 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $33.88 Median $100.00 Typical High $151.36 | Professional | None | $33.88 | $100.00 | $151.36 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $213.80 Typical High $1,288.25 | Facility | None | $93.33 | $213.80 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $331.13 | Professional | None | $67.61 | $125.89 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $158.49 Typical High $218.78 | Professional | None | $85.11 | $158.49 | $218.78 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $102.33 Typical High $120.23 | Facility | None | $100.00 | $102.33 | $120.23 |
Oscar Health Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Oscar Health Setting Professional Modifier None Typical Low $38.02 Median $85.11 Typical High $186.21 | Professional | None | $38.02 | $85.11 | $186.21 |
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 $41.69 Median $89.13 Typical High $199.53 | Professional | None | $41.69 | $89.13 | $199.53 |
Wellmark Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $177.83 | Professional | None | $70.79 | $77.62 | $177.83 |
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 $18.20 Median $28.84 Typical High $64.57 | Professional | 52 · Reduced service | $18.20 | $28.84 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $11.48 Typical High $25.70 | Professional | 53 · Discontinued | $7.24 | $11.48 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $42.66 Typical High $95.50 | Professional | 54 · Surgery only | $26.92 | $42.66 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $8.71 Typical High $19.05 | Professional | 55 · Aftercare only | $5.37 | $8.71 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $3.63 | $5.75 | $12.88 |
Where Iowa sits
The same service costs 3.7 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· 9th of 51
$102
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.