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 $257.04 Median $3,090.30 Typical High $6,760.83 | Facility | None | $257.04 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $549.54 Typical High $977.24 | Professional | None | $154.88 | $549.54 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $1,445.44 | Professional | None | $295.12 | $446.68 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $776.25 Typical High $1,258.93 | Professional | None | $128.82 | $776.25 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,258.93 Typical High $1,698.24 | Facility | None | $346.74 | $1,258.93 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,230.27 Typical High $4,265.80 | Professional | None | $295.12 | $1,230.27 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $1,071.52 Typical High $1,445.44 | Professional | None | $309.03 | $1,071.52 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $1,621.81 | Professional | None | $295.12 | $467.74 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $338.84 Typical High $1,202.26 | Professional | None | $144.54 | $338.84 | $1,202.26 |
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 $158.49 Median $562.34 Typical High $1,621.81 | Professional | None | $158.49 | $562.34 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $1,380.38 | Professional | None | $257.04 | $316.23 | $1,380.38 |
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 $77.62 Median $269.15 Typical High $446.68 | Professional | 52 · Reduced service | $77.62 | $269.15 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $109.65 Typical High $181.97 | Professional | 53 · Discontinued | $30.90 | $109.65 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $407.38 Typical High $676.08 | Professional | 54 · Surgery only | $117.49 | $407.38 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $81.28 Typical High $134.90 | Professional | 55 · Aftercare only | $23.44 | $81.28 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $54.95 Typical High $91.20 | Professional | 56 · Pre-op care only | $15.49 | $54.95 | $91.20 |
Where Iowa sits
The same service costs 3.8 times more in Wisconsin 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· 3rd of 51
$832
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.