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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,548.82 Typical High $3,090.30 | Professional | None | $346.74 | $1,548.82 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $4,466.84 | Professional | None | $549.54 | $1,047.13 | $4,466.84 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $2,344.23 Typical High $3,890.45 | Professional | None | $309.03 | $2,344.23 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $2,884.03 Typical High $4,897.79 | Facility | None | $851.14 | $2,884.03 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $3,890.45 Typical High $13,182.57 | Professional | None | $691.83 | $3,890.45 | $13,182.57 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $3,388.44 Typical High $4,897.79 | Professional | None | $741.31 | $3,388.44 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $4,897.79 | Professional | None | $645.65 | $933.25 | $4,897.79 |
Oscar Health Setting Professional Modifier None Typical Low $354.81 Median $831.76 Typical High $4,073.80 | Professional | None | $354.81 | $831.76 | $4,073.80 |
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 $371.54 Median $1,659.59 Typical High $5,128.61 | Professional | None | $371.54 | $1,659.59 | $5,128.61 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $4,897.79 | Professional | None | $630.96 | $776.25 | $4,897.79 |
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 $181.97 Median $776.25 Typical High $1,445.44 | Professional | 52 · Reduced service | $181.97 | $776.25 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $309.03 Typical High $575.44 | Professional | 53 · Discontinued | $74.13 | $309.03 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,174.90 Typical High $2,137.96 | Professional | 54 · Surgery only | $275.42 | $1,174.90 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $234.42 Typical High $436.52 | Professional | 55 · Aftercare only | $54.95 | $234.42 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $154.88 Typical High $288.40 | Professional | 56 · Pre-op care only | $36.31 | $154.88 | $288.40 |
Where Iowa sits
The same service costs 5.5 times more in Washington 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· 3rd of 51
$2,399
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.