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 $2,951.21 Typical High $6,760.83 | Facility | None | $467.74 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $741.31 Typical High $1,380.38 | Professional | None | $263.03 | $741.31 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $776.25 Typical High $2,290.87 | Professional | None | $467.74 | $776.25 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $1,096.48 Typical High $2,344.23 | Professional | None | $229.09 | $1,096.48 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $1,737.80 Typical High $2,511.89 | Facility | None | $660.69 | $1,737.80 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,819.70 Typical High $7,244.36 | Professional | None | $537.03 | $1,819.70 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $1,513.56 Typical High $2,290.87 | Professional | None | $549.54 | $1,513.56 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $2,290.87 | Professional | None | $524.81 | $776.25 | $2,290.87 |
Oscar Health Setting Professional Modifier None Typical Low $269.15 Median $602.56 Typical High $1,659.59 | Professional | None | $269.15 | $602.56 | $1,659.59 |
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 $288.40 Median $870.96 Typical High $2,398.83 | Professional | None | $288.40 | $870.96 | $2,398.83 |
Wellmark Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $1,949.84 | Professional | None | $457.09 | $562.34 | $1,949.84 |
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 $141.25 Median $380.19 Typical High $645.65 | Professional | 52 · Reduced service | $141.25 | $380.19 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $154.88 Typical High $257.04 | Professional | 53 · Discontinued | $56.23 | $154.88 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $575.44 Typical High $954.99 | Professional | 54 · Surgery only | $213.80 | $575.44 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $114.82 Typical High $190.55 | Professional | 55 · Aftercare only | $42.66 | $114.82 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $77.62 Typical High $128.82 | Professional | 56 · Pre-op care only | $28.18 | $77.62 | $128.82 |
Where Iowa sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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
$1,202
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.