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 $316.23 Median $2,630.27 Typical High $6,760.83 | Facility | None | $316.23 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $173.78 Typical High $316.23 | Professional | None | $81.28 | $173.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $269.15 Typical High $331.13 | Facility | None | $213.80 | $269.15 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $457.09 | Professional | None | $177.83 | $239.88 | $457.09 |
Hally Health Setting Professional Modifier None Typical Low $75.86 Median $190.55 Typical High $446.68 | Professional | None | $75.86 | $190.55 | $446.68 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $512.86 Typical High $3,162.28 | Facility | None | $213.80 | $512.86 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $416.87 Typical High $1,412.54 | Professional | None | $177.83 | $416.87 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $363.08 Typical High $478.63 | Professional | None | $181.97 | $363.08 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $331.13 | Facility | None | $194.98 | $245.47 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $524.81 | Professional | None | $223.87 | $371.54 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $77.62 Median $173.78 Typical High $407.38 | Professional | None | $77.62 | $173.78 | $407.38 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $5,495.41 | Facility | None | $724.44 | $2,398.83 | $5,495.41 |
United Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $446.68 | Professional | None | $95.50 | $204.17 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $478.63 | Professional | None | $151.36 | $173.78 | $478.63 |
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 $42.66 Median $83.18 Typical High $158.49 | Professional | 52 · Reduced service | $42.66 | $83.18 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $33.11 Typical High $63.10 | Professional | 53 · Discontinued | $16.98 | $33.11 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $123.03 Typical High $239.88 | Professional | 54 · Surgery only | $63.10 | $123.03 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $24.55 Typical High $47.86 | Professional | 55 · Aftercare only | $12.59 | $24.55 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $16.60 Typical High $31.62 | Professional | 56 · Pre-op care only | $8.51 | $16.60 | $31.62 |
Where Iowa sits
The same service costs 3.7 times more in Alaska 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· 4th of 51
$282
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.