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 $851.14 Median $2,951.21 Typical High $6,760.83 | Facility | None | $851.14 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $851.14 | Professional | None | $562.34 | $851.14 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $1,202.26 Typical High $1,202.26 | Professional | None | $537.03 | $1,202.26 | $1,202.26 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $575.44 | Professional | None | $275.42 | $446.68 | $575.44 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $1,380.38 Typical High $7,413.10 | Facility | None | $602.56 | $1,380.38 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $831.76 Typical High $4,466.84 | Professional | None | $309.03 | $831.76 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,202.26 | Professional | None | $602.56 | $1,023.29 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $2,238.72 | Professional | None | $537.03 | $537.03 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,288.25 | $1,445.44 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,380.38 | $3,981.07 | $8,128.31 |
United Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $758.58 | Professional | None | $281.84 | $446.68 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
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 $275.42 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $275.42 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $112.20 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $416.87 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $83.18 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $56.23 | $85.11 | $85.11 |
Where Iowa sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 20th of 51
$776
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.