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 $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $380.19 | Professional | None | $218.78 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,548.82 | Facility | None | $707.95 | $1,071.52 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $549.54 Typical High $616.60 | Professional | None | $239.88 | $549.54 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $1,000.00 | Professional | None | $208.93 | $309.03 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,148.15 Typical High $3,890.45 | Facility | None | $446.68 | $1,148.15 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,698.24 | Professional | None | $269.15 | $537.03 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $616.60 | Professional | None | $512.86 | $575.44 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,548.82 | Facility | None | $707.95 | $1,071.52 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $616.60 | Professional | None | $467.74 | $575.44 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $380.19 Typical High $478.63 | Professional | None | $204.17 | $380.19 | $478.63 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $5,495.41 | Facility | None | $724.44 | $2,754.23 | $5,495.41 |
United Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $645.65 | Professional | None | $245.47 | $354.81 | $645.65 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | None | $446.68 | $446.68 | $501.19 |
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 $107.15 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $107.15 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $42.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $158.49 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $31.62 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $21.38 | $38.02 | $38.02 |
Where Iowa sits
The same service costs 4.7 times more in Wyoming 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· 7th of 51
$457
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.