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 $104.71 Median $1,288.25 Typical High $6,606.93 | Facility | None | $104.71 | $1,288.25 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $181.97 | Professional | None | $53.70 | $100.00 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $72.44 Typical High $104.71 | Facility | None | $61.66 | $72.44 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $194.98 | Professional | None | $117.49 | $165.96 | $194.98 |
Hally Health Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $229.09 | Professional | None | $48.98 | $109.65 | $229.09 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $213.80 Typical High $1,621.81 | Facility | None | $79.43 | $213.80 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $1,148.15 | Professional | None | $100.00 | $165.96 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $186.21 | Professional | None | $100.00 | $144.54 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $54.95 Median $77.62 Typical High $109.65 | Facility | None | $54.95 | $77.62 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $194.98 | Professional | None | $120.23 | $190.55 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $177.83 | Professional | None | $53.70 | $97.72 | $177.83 |
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 $60.26 Median $104.71 Typical High $190.55 | Professional | None | $60.26 | $104.71 | $190.55 |
Wellmark Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $186.21 | Professional | None | $91.20 | $125.89 | $186.21 |
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 $25.12 Median $36.31 Typical High $52.48 | Professional | 52 · Reduced service | $25.12 | $36.31 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $14.79 Typical High $20.89 | Professional | 53 · Discontinued | $10.00 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $54.95 Typical High $79.43 | Professional | 54 · Surgery only | $37.15 | $54.95 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $10.96 Typical High $15.85 | Professional | 55 · Aftercare only | $7.59 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.24 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.01 | $7.24 | $10.47 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$126
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.