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 $91.20 Median $2,630.27 Typical High $6,760.83 | Facility | None | $91.20 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $102.33 | Professional | None | $48.98 | $83.18 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $48.98 Typical High $74.13 | Facility | None | $38.02 | $48.98 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $114.82 Typical High $151.36 | Professional | None | $69.18 | $114.82 | $151.36 |
Hally Health Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $147.91 | Professional | None | $42.66 | $67.61 | $147.91 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $158.49 Typical High $1,288.25 | Facility | None | $54.95 | $158.49 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $426.58 | Professional | None | $91.20 | $134.90 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $141.25 | Professional | None | $104.71 | $114.82 | $141.25 |
Midlands Setting Facility Modifier None Typical Low $34.67 Median $50.12 Typical High $77.62 | Facility | None | $34.67 | $50.12 | $77.62 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Oscar Health Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $109.65 | Professional | None | $41.69 | $77.62 | $109.65 |
United Setting Facility Modifier None Typical Low $223.87 Median $851.14 Typical High $1,995.26 | Facility | None | $223.87 | $851.14 | $1,995.26 |
United Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $218.78 | Professional | None | $64.57 | $112.20 | $218.78 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $125.89 | Professional | None | $79.43 | $93.33 | $125.89 |
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 $26.30 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $26.30 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $16.60 Typical High $18.20 | Professional | 53 · Discontinued | $10.72 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $61.66 Typical High $67.61 | Professional | 54 · Surgery only | $39.81 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $7.94 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $8.32 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.37 | $8.32 | $9.12 |
Where Iowa sits
The same service costs 3.6 times more in Wyoming 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· 4th of 51
$115
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.