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 $331.13 Median $2,630.27 Typical High $6,760.83 | Facility | None | $331.13 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $173.78 Typical High $331.13 | Professional | None | $85.11 | $173.78 | $331.13 |
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 $177.83 Median $263.03 Typical High $478.63 | Professional | None | $177.83 | $263.03 | $478.63 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $194.98 Typical High $512.86 | Professional | None | $77.62 | $194.98 | $512.86 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $645.65 Typical High $6,309.57 | Facility | None | $208.93 | $645.65 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $416.87 Typical High $1,479.11 | Professional | None | $147.91 | $416.87 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $512.86 | Professional | None | $199.53 | $371.54 | $512.86 |
Midlands Setting Facility Modifier None Typical Low $741.31 Median $2,290.87 Typical High $2,818.38 | Facility | None | $741.31 | $2,290.87 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $575.44 | Professional | None | $208.93 | $309.03 | $575.44 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $478.63 | Professional | None | $93.33 | $208.93 | $478.63 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $7,413.10 | Facility | None | $724.44 | $3,090.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $91.20 Median $194.98 Typical High $426.58 | Professional | None | $91.20 | $194.98 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $562.34 | Professional | None | $181.97 | $208.93 | $562.34 |
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 $42.66 Median $83.18 Typical High $165.96 | Professional | 52 · Reduced service | $42.66 | $83.18 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $33.11 Typical High $66.07 | Professional | 53 · Discontinued | $16.98 | $33.11 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $123.03 Typical High $245.47 | Professional | 54 · Surgery only | $64.57 | $123.03 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $25.12 Typical High $48.98 | Professional | 55 · Aftercare only | $12.88 | $25.12 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $16.60 Typical High $33.11 | Professional | 56 · Pre-op care only | $8.51 | $16.60 | $33.11 |
Where Iowa sits
The same service costs 4.5 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· 7th of 51
$263
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.