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 $1,071.52 Median $2,951.21 Typical High $6,760.83 | Facility | None | $1,071.52 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,071.52 | Professional | None | $616.60 | $1,071.52 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,230.27 | $1,479.11 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,398.83 | Professional | None | $645.65 | $891.25 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $1,174.90 Typical High $1,949.84 | Facility | None | $302.00 | $1,174.90 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,513.56 Typical High $5,011.87 | Professional | None | $741.31 | $1,513.56 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,905.46 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $630.96 Median $1,174.90 Typical High $1,479.11 | Professional | None | $630.96 | $1,174.90 | $1,479.11 |
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 $660.69 Median $1,000.00 Typical High $1,819.70 | Professional | None | $660.69 | $1,000.00 | $1,819.70 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
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 $309.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $309.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $457.09 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $93.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $61.66 | $107.15 | $107.15 |
Where Iowa sits
The same service costs 4.7 times more in Alaska than in Utah. 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
$1,259
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.