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 $346.74 Median $2,630.27 Typical High $6,760.83 | Facility | None | $346.74 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $346.74 | Professional | None | $107.15 | $181.97 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $2,818.38 | Facility | None | $645.65 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $489.78 | Professional | None | $194.98 | $275.42 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $239.88 Typical High $562.34 | Professional | None | $93.33 | $239.88 | $562.34 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $851.14 Typical High $7,079.46 | Facility | None | $234.42 | $851.14 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $436.52 Typical High $1,548.82 | Professional | None | $218.78 | $436.52 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $524.81 | Professional | None | $223.87 | $380.19 | $524.81 |
Midlands Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,290.87 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $602.56 | Professional | None | $245.47 | $323.59 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $501.19 | Professional | None | $109.65 | $234.42 | $501.19 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,585.78 | Facility | None | $1,258.93 | $3,630.78 | $7,585.78 |
United Setting Professional Modifier None Typical Low $107.15 Median $213.80 Typical High $457.09 | Professional | None | $107.15 | $213.80 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $575.44 | Professional | None | $213.80 | $245.47 | $575.44 |
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 $51.29 Median $89.13 Typical High $173.78 | Professional | 52 · Reduced service | $51.29 | $89.13 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $36.31 Typical High $69.18 | Professional | 53 · Discontinued | $20.42 | $36.31 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $134.90 Typical High $257.04 | Professional | 54 · Surgery only | $75.86 | $134.90 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $26.92 Typical High $51.29 | Professional | 55 · Aftercare only | $15.14 | $26.92 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $18.20 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.23 | $18.20 | $34.67 |
Where Iowa sits
The same service costs 4.0 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· 9th of 51
$282
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.