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 $69.18 Median $2,511.89 Typical High $6,760.83 | Facility | None | $69.18 | $2,511.89 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $100.00 Typical High $229.09 | Professional | None | $39.81 | $100.00 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Facility | None | $45.71 | $45.71 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $125.89 Typical High $288.40 | Professional | None | $85.11 | $125.89 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $38.02 Median $125.89 Typical High $302.00 | Professional | None | $38.02 | $125.89 | $302.00 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $239.88 Typical High $1,288.25 | Facility | None | $102.33 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $870.96 | Professional | None | $79.43 | $223.87 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $208.93 Typical High $295.12 | Professional | None | $95.50 | $208.93 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $53.70 | Facility | None | $45.71 | $48.98 | $53.70 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $331.13 | Professional | None | $104.71 | $173.78 | $331.13 |
Oscar Health Setting Professional Modifier None Typical Low $43.65 Median $97.72 Typical High $269.15 | Professional | None | $43.65 | $97.72 | $269.15 |
United Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $1,995.26 | Facility | None | $173.78 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $239.88 | Professional | None | $45.71 | $102.33 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $316.23 | Professional | None | $89.13 | $102.33 | $316.23 |
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 $20.89 Median $38.02 Typical High $95.50 | Professional | 52 · Reduced service | $20.89 | $38.02 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.14 Typical High $38.02 | Professional | 53 · Discontinued | $8.32 | $15.14 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $56.23 Typical High $141.25 | Professional | 54 · Surgery only | $31.62 | $56.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $11.22 Typical High $28.18 | Professional | 55 · Aftercare only | $6.31 | $11.22 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.59 Typical High $19.05 | Professional | 56 · Pre-op care only | $4.17 | $7.59 | $19.05 |
Where Iowa sits
The same service costs 3.4 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
$132
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.