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 $138.04 Median $2,290.87 Typical High $6,760.83 | Facility | None | $138.04 | $2,290.87 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $371.54 Typical High $707.95 | Professional | None | $70.79 | $371.54 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $1,047.13 | Professional | None | $154.88 | $354.81 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $72.44 Median $489.78 Typical High $1,000.00 | Professional | None | $72.44 | $489.78 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $891.25 Typical High $9,120.11 | Facility | None | $181.97 | $891.25 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $891.25 Typical High $3,090.30 | Professional | None | $173.78 | $891.25 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $776.25 Typical High $1,047.13 | Professional | None | $154.88 | $776.25 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $977.24 Typical High $1,174.90 | Professional | None | $165.96 | $977.24 | $1,174.90 |
Oscar Health Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $812.83 | Professional | None | $67.61 | $151.36 | $812.83 |
United Setting Facility Modifier None Typical Low $4,786.30 Median $7,762.47 Typical High $10,964.78 | Facility | None | $4,786.30 | $7,762.47 | $10,964.78 |
United Setting Professional Modifier None Typical Low $83.18 Median $338.84 Typical High $1,047.13 | Professional | None | $83.18 | $338.84 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $977.24 | Professional | None | $138.04 | $158.49 | $977.24 |
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 $34.67 Median $100.00 Typical High $331.13 | Professional | 52 · Reduced service | $34.67 | $100.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $39.81 Typical High $134.90 | Professional | 53 · Discontinued | $13.80 | $39.81 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $151.36 Typical High $501.19 | Professional | 54 · Surgery only | $52.48 | $151.36 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $30.20 Typical High $100.00 | Professional | 55 · Aftercare only | $10.47 | $30.20 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $19.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $6.92 | $19.95 | $67.61 |
Where Iowa sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 3rd of 51
$562
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.