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 $114.82 Median $2,511.89 Typical High $6,760.83 | Facility | None | $114.82 | $2,511.89 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $204.17 | Professional | None | $45.71 | $95.50 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $114.82 | Facility | None | $75.86 | $100.00 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $229.09 | Professional | None | $102.33 | $165.96 | $229.09 |
Hally Health Setting Professional Modifier None Typical Low $42.66 Median $125.89 Typical High $251.19 | Professional | None | $42.66 | $125.89 | $251.19 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $229.09 Typical High $1,288.25 | Facility | None | $102.33 | $229.09 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $1,023.29 | Professional | None | $97.72 | $162.18 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $204.17 | Professional | None | $87.10 | $141.25 | $204.17 |
Midlands Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $114.82 | Facility | None | $77.62 | $100.00 | $114.82 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $234.42 | Professional | None | $114.82 | $194.98 | $234.42 |
Oscar Health Setting Professional Modifier None Typical Low $42.66 Median $85.11 Typical High $169.82 | Professional | None | $42.66 | $85.11 | $169.82 |
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 $50.12 Median $104.71 Typical High $199.53 | Professional | None | $50.12 | $104.71 | $199.53 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $125.89 Typical High $186.21 | Professional | None | $77.62 | $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 $21.88 Median $38.02 Typical High $57.54 | Professional | 52 · Reduced service | $21.88 | $38.02 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $15.14 Typical High $22.91 | Professional | 53 · Discontinued | $8.71 | $15.14 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $56.23 Typical High $85.11 | Professional | 54 · Surgery only | $33.11 | $56.23 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $11.22 Typical High $16.98 | Professional | 55 · Aftercare only | $6.61 | $11.22 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $7.59 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.37 | $7.59 | $11.48 |
Where Iowa sits
The same service costs 3.0 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· 8th 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.