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 $199.53 Median $2,238.72 Typical High $6,760.83 | Facility | None | $199.53 | $2,238.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $218.78 | Professional | None | $61.66 | $123.03 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $1,202.26 Typical High $1,445.44 | Facility | None | $346.74 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $416.87 | Professional | None | $154.88 | $269.15 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $204.17 Typical High $346.74 | Professional | None | $63.10 | $204.17 | $346.74 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $645.65 Typical High $4,677.35 | Facility | None | $181.97 | $645.65 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $676.08 | Professional | None | $144.54 | $302.00 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $331.13 Typical High $416.87 | Professional | None | $154.88 | $331.13 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $1,174.90 Typical High $1,445.44 | Facility | None | $380.19 | $1,174.90 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $489.78 | Professional | None | $131.83 | $213.80 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $72.44 Median $158.49 Typical High $346.74 | Professional | None | $72.44 | $158.49 | $346.74 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $371.54 | Professional | None | $79.43 | $169.82 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $363.08 | Professional | None | $114.82 | $134.90 | $363.08 |
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 $30.90 Median $52.48 Typical High $109.65 | Professional | 52 · Reduced service | $30.90 | $52.48 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $20.89 Typical High $43.65 | Professional | 53 · Discontinued | $12.30 | $20.89 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $77.62 Typical High $162.18 | Professional | 54 · Surgery only | $45.71 | $77.62 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $15.49 Typical High $33.11 | Professional | 55 · Aftercare only | $9.12 | $15.49 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $10.47 Typical High $21.88 | Professional | 56 · Pre-op care only | $6.17 | $10.47 | $21.88 |
Where Iowa sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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
$251
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.