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 $323.59 Median $2,137.96 Typical High $6,309.57 | Facility | None | $323.59 | $2,137.96 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $524.81 Typical High $1,148.15 | Professional | None | $158.49 | $524.81 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,230.27 | Facility | None | $851.14 | $1,071.52 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $1,737.80 | Professional | None | $331.13 | $524.81 | $1,737.80 |
Hally Health Setting Professional Modifier None Typical Low $162.18 Median $812.83 Typical High $1,258.93 | Professional | None | $162.18 | $812.83 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,174.90 Typical High $4,677.35 | Facility | None | $407.38 | $1,174.90 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,412.54 Typical High $5,128.61 | Professional | None | $407.38 | $1,412.54 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $1,230.27 Typical High $1,737.80 | Professional | None | $331.13 | $1,230.27 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $776.25 Median $977.24 Typical High $1,230.27 | Facility | None | $776.25 | $977.24 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $1,548.82 Typical High $2,089.30 | Professional | None | $354.81 | $1,548.82 | $2,089.30 |
Oscar Health Setting Professional Modifier None Typical Low $165.96 Median $380.19 Typical High $1,412.54 | Professional | None | $165.96 | $380.19 | $1,412.54 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $194.98 Median $676.08 Typical High $1,778.28 | Professional | None | $194.98 | $676.08 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $1,698.24 | Professional | None | $309.03 | $380.19 | $1,698.24 |
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 $91.20 Median $309.03 Typical High $549.54 | Professional | 52 · Reduced service | $91.20 | $309.03 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $123.03 Typical High $218.78 | Professional | 53 · Discontinued | $36.31 | $123.03 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $467.74 Typical High $812.83 | Professional | 54 · Surgery only | $138.04 | $467.74 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $93.33 Typical High $162.18 | Professional | 55 · Aftercare only | $27.54 | $93.33 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $61.66 Typical High $109.65 | Professional | 56 · Pre-op care only | $18.20 | $61.66 | $109.65 |
Where Iowa sits
The same service costs 5.2 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
$955
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.