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 $218.78 Median $912.01 Typical High $1,513.56 | Professional | None | $218.78 | $912.01 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $977.24 Typical High $2,570.40 | Professional | None | $416.87 | $977.24 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $181.97 Median $912.01 Typical High $1,659.59 | Professional | None | $181.97 | $912.01 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $2,238.72 Typical High $8,511.38 | Facility | None | $512.86 | $2,238.72 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $2,290.87 Typical High $7,079.46 | Professional | None | $467.74 | $2,290.87 | $7,079.46 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $1,778.28 Typical High $2,398.83 | Professional | None | $436.52 | $1,778.28 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $2,238.72 Typical High $2,691.53 | Professional | None | $416.87 | $2,238.72 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $208.93 Median $489.78 Typical High $1,949.84 | Professional | None | $208.93 | $489.78 | $1,949.84 |
United Setting Facility Modifier None Typical Low $4,677.35 Median $7,244.36 Typical High $10,232.93 | Facility | None | $4,677.35 | $7,244.36 | $10,232.93 |
United Setting Professional Modifier None Typical Low $229.09 Median $912.01 Typical High $2,884.03 | Professional | None | $229.09 | $912.01 | $2,884.03 |
Wellmark Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $2,344.23 | Professional | None | $371.54 | $457.09 | $2,344.23 |
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 $112.20 Median $457.09 Typical High $758.58 | Professional | 52 · Reduced service | $112.20 | $457.09 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $181.97 Typical High $302.00 | Professional | 53 · Discontinued | $44.67 | $181.97 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $676.08 Typical High $1,122.02 | Professional | 54 · Surgery only | $169.82 | $676.08 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $134.90 Typical High $223.87 | Professional | 55 · Aftercare only | $33.88 | $134.90 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $91.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $22.39 | $91.20 | $151.36 |
Where Iowa sits
The same service costs 5.9 times more in Wisconsin than in Maryland. 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
$1,514
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.