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 $501.19 Median $3,388.44 Typical High $6,760.83 | Facility | None | $501.19 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $501.19 | Professional | None | $269.15 | $363.08 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $3,715.35 Typical High $4,466.84 | Facility | None | $478.63 | $3,715.35 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,096.48 | Professional | None | $645.65 | $831.76 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,071.52 | Professional | None | $269.15 | $537.03 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,000.00 Typical High $10,232.93 | Facility | None | $588.84 | $1,000.00 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $4,897.79 | Professional | None | $537.03 | $794.33 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,096.48 | Professional | None | $645.65 | $870.96 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $512.86 Median $3,715.35 Typical High $4,466.84 | Facility | None | $512.86 | $3,715.35 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,202.26 | Professional | None | $562.34 | $831.76 | $1,202.26 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $851.14 | Professional | None | $257.04 | $478.63 | $851.14 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $13,182.57 | Facility | None | $501.19 | $1,949.84 | $13,182.57 |
United Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $1,071.52 | Professional | None | $331.13 | $616.60 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $933.25 | Professional | None | $478.63 | $562.34 | $933.25 |
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 $134.90 Median $181.97 Typical High $251.19 | Professional | 52 · Reduced service | $134.90 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $72.44 Typical High $100.00 | Professional | 53 · Discontinued | $53.70 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $269.15 Typical High $380.19 | Professional | 54 · Surgery only | $204.17 | $269.15 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $75.86 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $36.31 Typical High $50.12 | Professional | 56 · Pre-op care only | $26.92 | $36.31 | $50.12 |
Where Iowa sits
The same service costs 3.9 times more in Alaska than in New York. 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
$741
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.