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 $363.08 Median $2,630.27 Typical High $6,760.83 | Facility | None | $363.08 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $363.08 | Professional | None | $112.20 | $199.53 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,288.25 | Facility | None | $645.65 | $1,047.13 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $512.86 | Professional | None | $213.80 | $316.23 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $245.47 Typical High $616.60 | Professional | None | $102.33 | $245.47 | $616.60 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $676.08 Typical High $3,801.89 | Facility | None | $295.12 | $676.08 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $1,621.81 | Professional | None | $208.93 | $467.74 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $549.54 | Professional | None | $257.04 | $407.38 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,288.25 | Facility | None | $645.65 | $1,047.13 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $616.60 | Professional | None | $275.42 | $354.81 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $501.19 | Professional | None | $114.82 | $239.88 | $501.19 |
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 $125.89 Median $245.47 Typical High $489.78 | Professional | None | $125.89 | $245.47 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $588.84 | Professional | None | $229.09 | $263.03 | $588.84 |
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 $56.23 Median $95.50 Typical High $177.83 | Professional | 52 · Reduced service | $56.23 | $95.50 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.02 Typical High $72.44 | Professional | 53 · Discontinued | $22.39 | $38.02 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $144.54 Typical High $269.15 | Professional | 54 · Surgery only | $85.11 | $144.54 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.84 Typical High $53.70 | Professional | 55 · Aftercare only | $16.98 | $28.84 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.05 Typical High $36.31 | Professional | 56 · Pre-op care only | $11.22 | $19.05 | $36.31 |
Where Iowa sits
The same service costs 3.8 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· 8th of 51
$309
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.