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 $389.05 Median $5,888.44 Typical High $7,943.28 | Facility | None | $389.05 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $389.05 Typical High $389.05 | Professional | None | $218.78 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $660.69 | Professional | None | $295.12 | $537.03 | $660.69 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $812.83 | Professional | None | $223.87 | $380.19 | $812.83 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $645.65 Typical High $3,467.37 | Facility | None | $363.08 | $645.65 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $4,365.16 | Professional | None | $288.40 | $524.81 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $660.69 | Professional | None | $512.86 | $537.03 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $758.58 | Professional | None | $436.52 | $588.84 | $758.58 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $562.34 | Professional | None | $239.88 | $426.58 | $562.34 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $645.65 | Professional | None | $251.19 | $354.81 | $645.65 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $537.03 | Professional | None | $478.63 | $478.63 | $537.03 |
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 $109.65 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $38.90 | $38.90 |
Where Iowa sits
The same service costs 5.0 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· 5th of 51
$525
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.