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 $288.40 Median $3,388.44 Typical High $6,760.83 | Facility | None | $288.40 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $288.40 | Professional | None | $91.20 | $151.36 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $2,818.38 | Facility | None | $954.99 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $416.87 | Professional | None | $169.82 | $257.04 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $234.42 Typical High $407.38 | Professional | None | $83.18 | $234.42 | $407.38 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $954.99 Typical High $7,079.46 | Facility | None | $245.47 | $954.99 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $1,318.26 | Professional | None | $194.98 | $371.54 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $446.68 | Professional | None | $213.80 | $331.13 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,290.87 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $489.78 | Professional | None | $239.88 | $288.40 | $489.78 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $190.55 Typical High $398.11 | Professional | None | $93.33 | $190.55 | $398.11 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,585.78 | Facility | None | $1,258.93 | $3,630.78 | $7,585.78 |
United Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $380.19 | Professional | None | $104.71 | $190.55 | $380.19 |
Wellmark Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $467.74 | Professional | None | $186.21 | $213.80 | $467.74 |
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 $45.71 Median $75.86 Typical High $144.54 | Professional | 52 · Reduced service | $45.71 | $75.86 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $30.20 Typical High $57.54 | Professional | 53 · Discontinued | $18.20 | $30.20 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $114.82 Typical High $213.80 | Professional | 54 · Surgery only | $69.18 | $114.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.91 Typical High $43.65 | Professional | 55 · Aftercare only | $13.80 | $22.91 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $15.14 Typical High $28.84 | Professional | 56 · Pre-op care only | $9.12 | $15.14 | $28.84 |
Where Iowa sits
The same service costs 3.6 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
$269
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.