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 $275.42 Median $2,630.27 Typical High $6,760.83 | Facility | None | $275.42 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $151.36 Typical High $275.42 | Professional | None | $66.07 | $151.36 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $239.88 Typical High $309.03 | Facility | None | $154.88 | $239.88 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $398.11 | Professional | None | $123.03 | $186.21 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $58.88 Median $213.80 Typical High $467.74 | Professional | None | $58.88 | $213.80 | $467.74 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $3,467.37 | Facility | None | $173.78 | $371.54 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $331.13 Typical High $1,230.27 | Professional | None | $128.82 | $331.13 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $288.40 Typical High $416.87 | Professional | None | $123.03 | $288.40 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $151.36 Median $234.42 Typical High $309.03 | Facility | None | $151.36 | $234.42 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $467.74 | Professional | None | $169.82 | $251.19 | $467.74 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $380.19 | Professional | None | $67.61 | $154.88 | $380.19 |
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 $74.13 Median $158.49 Typical High $346.74 | Professional | None | $74.13 | $158.49 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $446.68 | Professional | None | $134.90 | $158.49 | $446.68 |
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 $32.36 Median $60.26 Typical High $134.90 | Professional | 52 · Reduced service | $32.36 | $60.26 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $23.99 Typical High $54.95 | Professional | 53 · Discontinued | $12.88 | $23.99 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $89.13 Typical High $204.17 | Professional | 54 · Surgery only | $48.98 | $89.13 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $17.78 Typical High $40.74 | Professional | 55 · Aftercare only | $9.77 | $17.78 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $12.02 Typical High $27.54 | Professional | 56 · Pre-op care only | $6.46 | $12.02 | $27.54 |
Where Iowa sits
The same service costs 3.7 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· 4th of 51
$229
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.