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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $724.44 Typical High $1,348.96 | Professional | None | $208.93 | $724.44 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $2,089.30 | Professional | None | $389.05 | $660.69 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $954.99 Typical High $1,348.96 | Professional | None | $208.93 | $954.99 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $9,120.11 | Facility | None | $537.03 | $1,862.09 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,862.09 Typical High $6,165.95 | Professional | None | $512.86 | $1,862.09 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $1,548.82 Typical High $2,089.30 | Professional | None | $467.74 | $1,548.82 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $1,949.84 Typical High $2,290.87 | Professional | None | $501.19 | $1,949.84 | $2,290.87 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $1,659.59 | Professional | None | $204.17 | $457.09 | $1,659.59 |
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 $251.19 Median $794.33 Typical High $2,290.87 | Professional | None | $251.19 | $794.33 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $1,995.26 | Professional | None | $407.38 | $467.74 | $1,995.26 |
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 $104.71 Median $302.00 Typical High $676.08 | Professional | 52 · Reduced service | $104.71 | $302.00 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $120.23 Typical High $269.15 | Professional | 53 · Discontinued | $41.69 | $120.23 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $446.68 Typical High $1,000.00 | Professional | 54 · Surgery only | $158.49 | $446.68 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $89.13 Typical High $199.53 | Professional | 55 · Aftercare only | $31.62 | $89.13 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $60.26 Typical High $134.90 | Professional | 56 · Pre-op care only | $20.89 | $60.26 | $134.90 |
Where Iowa sits
The same service costs 5.4 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· 2nd of 51
$1,202
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.