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 $79.43 Median $162.18 Typical High $363.08 | Professional | None | $79.43 | $162.18 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $1,000.00 | Facility | None | $645.65 | $812.83 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $524.81 | Professional | None | $173.78 | $251.19 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $74.13 Median $288.40 Typical High $354.81 | Professional | None | $74.13 | $288.40 | $354.81 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $645.65 Typical High $3,467.37 | Facility | None | $223.87 | $645.65 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $457.09 Typical High $1,659.59 | Professional | None | $181.97 | $457.09 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $407.38 Typical High $562.34 | Professional | None | $186.21 | $407.38 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $616.60 Median $831.76 Typical High $1,000.00 | Facility | None | $616.60 | $831.76 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $616.60 | Professional | None | $213.80 | $346.74 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $83.18 Median $186.21 Typical High $501.19 | Professional | None | $83.18 | $186.21 | $501.19 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,454.71 Typical High $5,495.41 | Facility | None | $724.44 | $2,454.71 | $5,495.41 |
United Setting Professional Modifier None Typical Low $91.20 Median $199.53 Typical High $478.63 | Professional | None | $91.20 | $199.53 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $588.84 | Professional | None | $165.96 | $190.55 | $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 $40.74 Median $77.62 Typical High $177.83 | Professional | 52 · Reduced service | $40.74 | $77.62 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $30.90 Typical High $72.44 | Professional | 53 · Discontinued | $16.22 | $30.90 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $114.82 Typical High $269.15 | Professional | 54 · Surgery only | $61.66 | $114.82 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $23.44 Typical High $53.70 | Professional | 55 · Aftercare only | $12.30 | $23.44 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $15.49 Typical High $36.31 | Professional | 56 · Pre-op care only | $8.13 | $15.49 | $36.31 |
Where Iowa sits
The same service costs 4.1 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· 5th of 51
$288
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.