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 $154.88 Median $2,511.89 Typical High $6,760.83 | Facility | None | $154.88 | $2,511.89 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $114.82 Typical High $269.15 | Professional | None | $52.48 | $114.82 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $190.55 | Facility | None | $128.82 | $151.36 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $281.84 | Professional | None | $117.49 | $165.96 | $281.84 |
Hally Health Setting Professional Modifier None Typical Low $47.86 Median $158.49 Typical High $239.88 | Professional | None | $47.86 | $158.49 | $239.88 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $263.03 Typical High $1,288.25 | Facility | None | $123.03 | $263.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $245.47 Typical High $1,023.29 | Professional | None | $114.82 | $245.47 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $213.80 Typical High $281.84 | Professional | None | $100.00 | $213.80 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $190.55 | Facility | None | $123.03 | $151.36 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $295.12 | Professional | None | $128.82 | $245.47 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $120.23 Typical High $257.04 | Professional | None | $53.70 | $120.23 | $257.04 |
United Setting Facility Modifier None Typical Low $223.87 Median $831.76 Typical High $1,995.26 | Facility | None | $223.87 | $831.76 | $1,995.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $120.23 Typical High $263.03 | Professional | None | $56.23 | $120.23 | $263.03 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $190.55 Typical High $288.40 | Professional | None | $95.50 | $190.55 | $288.40 |
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 $24.55 Median $51.29 Typical High $77.62 | Professional | 52 · Reduced service | $24.55 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $20.42 Typical High $30.90 | Professional | 53 · Discontinued | $9.77 | $20.42 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $75.86 Typical High $117.49 | Professional | 54 · Surgery only | $36.31 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $15.49 Typical High $23.44 | Professional | 55 · Aftercare only | $7.41 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $10.23 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.90 | $10.23 | $15.49 |
Where Iowa sits
The same service costs 3.4 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· 8th of 51
$155
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.