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 $602.56 Median $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $501.19 | Professional | None | $331.13 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $2,754.23 | Facility | None | $645.65 | $645.65 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $1,000.00 | Professional | None | $707.95 | $776.25 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $977.24 | Professional | None | $331.13 | $575.44 | $977.24 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $912.01 Typical High $1,905.46 | Facility | None | $416.87 | $912.01 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $794.33 Typical High $2,630.27 | Professional | None | $416.87 | $794.33 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $977.24 | Professional | None | $660.69 | $776.25 | $977.24 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $2,570.40 Typical High $2,951.21 | Facility | None | $645.65 | $2,570.40 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,380.38 | Professional | None | $691.83 | $758.58 | $1,380.38 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $616.60 Typical High $776.25 | Professional | None | $331.13 | $616.60 | $776.25 |
United Setting Facility Modifier None Typical Low $158.49 Median $954.99 Typical High $1,995.26 | Facility | None | $158.49 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $1,023.29 | Professional | None | $363.08 | $562.34 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | None | $616.60 | $616.60 | $741.31 |
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 $165.96 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $165.96 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $66.07 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $48.98 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.11 | $50.12 | $50.12 |
Where Iowa sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 6th of 51
$708
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.