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 $537.03 Median $2,630.27 Typical High $6,760.83 | Facility | None | $537.03 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $295.12 Typical High $537.03 | Professional | None | $87.10 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $263.03 Typical High $323.59 | Facility | None | $208.93 | $263.03 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $776.25 | Professional | None | $194.98 | $316.23 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $380.19 Typical High $1,318.26 | Professional | None | $85.11 | $380.19 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $562.34 Typical High $1,202.26 | Facility | None | $190.55 | $562.34 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $707.95 Typical High $2,454.71 | Professional | None | $190.55 | $707.95 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $616.60 Typical High $831.76 | Professional | None | $194.98 | $616.60 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $177.83 Median $239.88 Typical High $323.59 | Facility | None | $177.83 | $239.88 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $831.76 Typical High $977.24 | Professional | None | $239.88 | $831.76 | $977.24 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $213.80 Typical High $758.58 | Professional | None | $93.33 | $213.80 | $758.58 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $95.50 Median $288.40 Typical High $794.33 | Professional | None | $95.50 | $288.40 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $912.01 | Professional | None | $181.97 | $213.80 | $912.01 |
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 $43.65 Median $123.03 Typical High $269.15 | Professional | 52 · Reduced service | $43.65 | $123.03 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $48.98 Typical High $107.15 | Professional | 53 · Discontinued | $17.38 | $48.98 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $181.97 Typical High $398.11 | Professional | 54 · Surgery only | $64.57 | $181.97 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $37.15 Typical High $79.43 | Professional | 55 · Aftercare only | $12.88 | $37.15 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $24.55 Typical High $53.70 | Professional | 56 · Pre-op care only | $8.71 | $24.55 | $53.70 |
Where Iowa sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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
$468
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.