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 $3,548.13 Typical High $6,760.83 | Facility | None | $602.56 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $588.84 | Professional | None | $338.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,754.23 | Facility | None | $954.99 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $1,000.00 | Professional | None | $457.09 | $776.25 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $616.60 Typical High $1,621.81 | Professional | None | $323.59 | $616.60 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $1,513.56 Typical High $6,309.57 | Facility | None | $660.69 | $1,513.56 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $2,818.38 | Professional | None | $467.74 | $758.58 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $954.99 | Professional | None | $776.25 | $776.25 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,137.96 | Facility | None | $1,348.96 | $1,737.80 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,096.48 | Professional | None | $691.83 | $891.25 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $741.31 | Professional | None | $316.23 | $588.84 | $741.31 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $1,047.13 | Professional | None | $380.19 | $575.44 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | None | $691.83 | $691.83 | $758.58 |
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 $165.96 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $165.96 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $66.07 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $245.47 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $50.12 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.11 | $58.88 | $58.88 |
Where Iowa sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 6th of 51
$759
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.