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 $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $190.55 | Professional | None | $107.15 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $6,025.60 Typical High $8,709.64 | Facility | None | $645.65 | $6,025.60 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $316.23 | Professional | None | $141.25 | $263.03 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $109.65 Median $154.88 Typical High $416.87 | Professional | None | $109.65 | $154.88 | $416.87 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $2,344.23 Typical High $12,302.69 | Facility | None | $190.55 | $2,344.23 | $12,302.69 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $851.14 | Professional | None | $134.90 | $257.04 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | None | $263.03 | $263.03 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $2,041.74 Median $6,025.60 Typical High $8,709.64 | Facility | None | $2,041.74 | $6,025.60 | $8,709.64 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $331.13 | Professional | None | $208.93 | $288.40 | $331.13 |
Oscar Health Setting Professional Modifier None Typical Low $114.82 Median $213.80 Typical High $275.42 | Professional | None | $114.82 | $213.80 | $275.42 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,365.16 | $15,848.93 |
United Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $316.23 | Professional | None | $120.23 | $165.96 | $316.23 |
Wellmark Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | None | $245.47 | $245.47 | $269.15 |
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 $52.48 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $52.48 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $20.89 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $144.54 Typical High $144.54 | Professional | 54 · Surgery only | $79.43 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $15.85 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.47 | $19.05 | $19.05 |
Where Iowa sits
The same service costs 4.8 times more in Alaska than in Utah. 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
$257
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.