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 $123.03 Median $1,288.25 Typical High $6,606.93 | Facility | None | $123.03 | $1,288.25 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $123.03 Typical High $239.88 | Professional | None | $57.54 | $123.03 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $95.50 Typical High $158.49 | Facility | None | $75.86 | $95.50 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $223.87 | Professional | None | $123.03 | $173.78 | $223.87 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $128.82 Typical High $309.03 | Professional | None | $52.48 | $128.82 | $309.03 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $263.03 Typical High $2,290.87 | Facility | None | $102.33 | $263.03 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $1,148.15 | Professional | None | $120.23 | $186.21 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $218.78 | Professional | None | $104.71 | $162.18 | $218.78 |
Midlands Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $169.82 | Facility | None | $70.79 | $95.50 | $169.82 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $288.40 | Professional | None | $141.25 | $223.87 | $288.40 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $190.55 | Professional | None | $53.70 | $100.00 | $190.55 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $66.07 Median $120.23 Typical High $229.09 | Professional | None | $66.07 | $120.23 | $229.09 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $208.93 | Professional | None | $95.50 | $141.25 | $208.93 |
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 $27.54 Median $40.74 Typical High $61.66 | Professional | 52 · Reduced service | $27.54 | $40.74 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.22 Typical High $24.55 | Professional | 53 · Discontinued | $10.96 | $16.22 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $60.26 Typical High $91.20 | Professional | 54 · Surgery only | $41.69 | $60.26 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.02 Typical High $18.20 | Professional | 55 · Aftercare only | $8.32 | $12.02 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.13 Typical High $12.30 | Professional | 56 · Pre-op care only | $5.50 | $8.13 | $12.30 |
Where Iowa sits
The same service costs 3.2 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· 9th of 51
$141
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.