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 $56.23 Median $123.03 Typical High $269.15 | Professional | None | $56.23 | $123.03 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $141.25 Typical High $177.83 | Facility | None | $107.15 | $141.25 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $288.40 | Professional | None | $123.03 | $190.55 | $288.40 |
Hally Health Setting Professional Modifier None Typical Low $52.48 Median $154.88 Typical High $309.03 | Professional | None | $52.48 | $154.88 | $309.03 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $302.00 Typical High $2,290.87 | Facility | None | $134.90 | $302.00 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $239.88 Typical High $1,380.38 | Professional | None | $117.49 | $239.88 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $281.84 | Professional | None | $104.71 | $208.93 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $177.83 | Facility | None | $107.15 | $138.04 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $302.00 | Professional | None | $141.25 | $263.03 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $53.70 Median $114.82 Typical High $251.19 | Professional | None | $53.70 | $114.82 | $251.19 |
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 $64.57 Median $144.54 Typical High $288.40 | Professional | None | $64.57 | $144.54 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $281.84 | Professional | None | $100.00 | $190.55 | $281.84 |
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 $26.92 Median $51.29 Typical High $77.62 | Professional | 52 · Reduced service | $26.92 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $20.42 Typical High $30.90 | Professional | 53 · Discontinued | $10.72 | $20.42 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $77.62 Typical High $117.49 | Professional | 54 · Surgery only | $39.81 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $15.49 Typical High $23.44 | Professional | 55 · Aftercare only | $7.94 | $15.49 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.23 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.37 | $10.23 | $15.49 |
Where Iowa sits
The same service costs 3.2 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
$162
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.