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 $467.74 Median $2,630.27 Typical High $6,760.83 | Facility | None | $467.74 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $208.93 Typical High $467.74 | Professional | None | $77.62 | $208.93 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $758.58 | Professional | None | $151.36 | $257.04 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $398.11 Typical High $741.31 | Professional | None | $75.86 | $398.11 | $741.31 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $457.09 Typical High $1,621.81 | Facility | None | $199.53 | $457.09 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $691.83 Typical High $2,691.53 | Professional | None | $199.53 | $691.83 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $549.54 Typical High $758.58 | Professional | None | $162.18 | $549.54 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $446.68 Typical High $851.14 | Professional | None | $154.88 | $446.68 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $660.69 | Professional | None | $79.43 | $177.83 | $660.69 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $724.44 | Professional | None | $97.72 | $269.15 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $794.33 | Professional | None | $144.54 | $177.83 | $794.33 |
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 $40.74 Median $89.13 Typical High $234.42 | Professional | 52 · Reduced service | $40.74 | $89.13 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $35.48 Typical High $93.33 | Professional | 53 · Discontinued | $16.22 | $35.48 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $134.90 Typical High $346.74 | Professional | 54 · Surgery only | $60.26 | $134.90 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $26.92 Typical High $69.18 | Professional | 55 · Aftercare only | $12.30 | $26.92 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $17.78 Typical High $46.77 | Professional | 56 · Pre-op care only | $8.13 | $17.78 | $46.77 |
Where Iowa sits
The same service costs 4.2 times more in Washington than in Virginia. 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· 2nd of 51
$417
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.