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 $199.53 Median $2,630.27 Typical High $6,760.83 | Facility | None | $199.53 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $234.42 | Professional | None | $104.71 | $162.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $112.20 Typical High $138.04 | Facility | None | $79.43 | $112.20 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $239.88 Typical High $316.23 | Professional | None | $138.04 | $239.88 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $354.81 | Professional | None | $83.18 | $147.91 | $354.81 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $302.00 Typical High $1,288.25 | Facility | None | $120.23 | $302.00 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $3,162.28 | Professional | None | $154.88 | $281.84 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $288.40 | Professional | None | $213.80 | $239.88 | $288.40 |
Midlands Setting Facility Modifier None Typical Low $72.44 Median $112.20 Typical High $138.04 | Facility | None | $72.44 | $112.20 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Oscar Health Setting Facility Modifier None Typical Low $354.81 Median $1,174.90 Typical High $3,311.31 | Facility | None | $354.81 | $1,174.90 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $239.88 | Professional | None | $81.28 | $151.36 | $239.88 |
United Setting Facility Modifier None Typical Low $223.87 Median $870.96 Typical High $1,995.26 | Facility | None | $223.87 | $870.96 | $1,995.26 |
United Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $316.23 | Professional | None | $112.20 | $199.53 | $316.23 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $281.84 | Professional | None | $158.49 | $186.21 | $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 $54.95 Median $81.28 Typical High $100.00 | Professional | 52 · Reduced service | $54.95 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $39.81 | Professional | 53 · Discontinued | $21.88 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $81.28 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $16.60 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.22 Typical High $19.95 | Professional | 56 · Pre-op care only | $10.96 | $16.22 | $19.95 |
Where Iowa sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$224
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.