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 $426.58 Median $2,630.27 Typical High $6,760.83 | Facility | None | $426.58 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $269.15 Typical High $426.58 | Professional | None | $141.25 | $269.15 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $776.25 | Professional | None | $309.03 | $436.52 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $131.83 Median $467.74 Typical High $977.24 | Professional | None | $131.83 | $467.74 | $977.24 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $724.44 Typical High $1,621.81 | Facility | None | $380.19 | $724.44 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $2,344.23 | Professional | None | $346.74 | $660.69 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $851.14 | Professional | None | $316.23 | $575.44 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $870.96 | Professional | None | $309.03 | $602.56 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $316.23 Typical High $691.83 | Professional | None | $144.54 | $316.23 | $691.83 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,630.78 | Facility | None | $1,096.48 | $1,737.80 | $3,630.78 |
United Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $912.01 | Professional | None | $186.21 | $389.05 | $912.01 |
Wellmark Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $794.33 | Professional | None | $269.15 | $323.59 | $794.33 |
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 $72.44 Median $134.90 Typical High $213.80 | Professional | 52 · Reduced service | $72.44 | $134.90 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $53.70 Typical High $87.10 | Professional | 53 · Discontinued | $28.84 | $53.70 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $199.53 Typical High $323.59 | Professional | 54 · Surgery only | $107.15 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $39.81 Typical High $64.57 | Professional | 55 · Aftercare only | $21.38 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.92 Typical High $42.66 | Professional | 56 · Pre-op care only | $14.45 | $26.92 | $42.66 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Virginia. 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
$490
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.