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 $2,630.27 Typical High $6,760.83 | Facility | None | $602.56 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $794.33 Typical High $1,479.11 | Professional | None | $87.10 | $794.33 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,548.82 | Facility | None | $741.31 | $1,071.52 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $2,187.76 | Professional | None | $190.55 | $371.54 | $2,187.76 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $1,122.02 Typical High $1,548.82 | Professional | None | $77.62 | $1,122.02 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,698.24 Typical High $3,630.78 | Facility | None | $239.88 | $1,698.24 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $1,949.84 Typical High $6,918.31 | Professional | None | $131.83 | $1,949.84 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $1,698.24 Typical High $2,344.23 | Professional | None | $190.55 | $1,698.24 | $2,344.23 |
Midlands Setting Facility Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,548.82 | Facility | None | $741.31 | $1,047.13 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $1,737.80 Typical High $2,691.53 | Professional | None | $213.80 | $1,737.80 | $2,691.53 |
Oscar Health Setting Professional Modifier None Typical Low $89.13 Median $204.17 Typical High $2,089.30 | Professional | None | $89.13 | $204.17 | $2,089.30 |
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 $93.33 Median $758.58 Typical High $2,238.72 | Professional | None | $93.33 | $758.58 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $2,511.89 | Professional | None | $177.83 | $204.17 | $2,511.89 |
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 $741.31 | Professional | 52 · Reduced service | $43.65 | $123.03 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $48.98 Typical High $295.12 | Professional | 53 · Discontinued | $17.38 | $48.98 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $186.21 Typical High $1,122.02 | Professional | 54 · Surgery only | $64.57 | $186.21 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $37.15 Typical High $223.87 | Professional | 55 · Aftercare only | $12.88 | $37.15 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $24.55 Typical High $147.91 | Professional | 56 · Pre-op care only | $8.71 | $24.55 | $147.91 |
Where Iowa sits
The same service costs 14.1 times more in Washington than in Kentucky. 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
$1,148
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.