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 $81.28 Median $2,630.27 Typical High $6,760.83 | Facility | None | $81.28 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $117.49 Typical High $257.04 | Professional | None | $48.98 | $117.49 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $194.98 Typical High $281.84 | Facility | None | $154.88 | $194.98 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $147.91 Typical High $316.23 | Professional | None | $104.71 | $147.91 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $44.67 Median $128.82 Typical High $257.04 | Professional | None | $44.67 | $128.82 | $257.04 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $338.84 Typical High $2,454.71 | Facility | None | $112.20 | $338.84 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $275.42 Typical High $954.99 | Professional | None | $102.33 | $275.42 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $245.47 Typical High $323.59 | Professional | None | $109.65 | $245.47 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $138.04 Median $190.55 Typical High $281.84 | Facility | None | $138.04 | $190.55 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $363.08 | Professional | None | $120.23 | $239.88 | $363.08 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $114.82 Typical High $309.03 | Professional | None | $50.12 | $114.82 | $309.03 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $4,073.80 | Facility | None | $501.19 | $1,819.70 | $4,073.80 |
United Setting Professional Modifier None Typical Low $52.48 Median $123.03 Typical High $288.40 | Professional | None | $52.48 | $123.03 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $363.08 | Professional | None | $100.00 | $114.82 | $363.08 |
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 $24.55 Median $50.12 Typical High $107.15 | Professional | 52 · Reduced service | $24.55 | $50.12 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $19.95 Typical High $42.66 | Professional | 53 · Discontinued | $9.77 | $19.95 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $74.13 Typical High $158.49 | Professional | 54 · Surgery only | $37.15 | $74.13 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $15.14 Typical High $32.36 | Professional | 55 · Aftercare only | $7.41 | $15.14 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $10.00 Typical High $21.38 | Professional | 56 · Pre-op care only | $4.90 | $10.00 | $21.38 |
Where Iowa sits
The same service costs 3.5 times more in Alaska 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· 6th of 51
$162
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.