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 $33.11 Median $5,011.87 Typical High $7,943.28 | Facility | None | $33.11 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $50.12 | Professional | None | $21.88 | $33.11 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $42.66 | Facility | None | $39.81 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $48.98 Typical High $66.07 | Professional | None | $29.51 | $48.98 | $66.07 |
Hally Health Setting Professional Modifier None Typical Low $18.20 Median $26.92 Typical High $95.50 | Professional | None | $18.20 | $26.92 | $95.50 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $138.04 Typical High $1,288.25 | Facility | None | $50.12 | $138.04 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $74.13 Typical High $645.65 | Professional | None | $40.74 | $74.13 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $60.26 | Professional | None | $41.69 | $48.98 | $60.26 |
Midlands Setting Facility Modifier None Typical Low $39.81 Median $42.66 Typical High $46.77 | Facility | None | $39.81 | $42.66 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Oscar Health Setting Professional Modifier None Typical Low $19.05 Median $34.67 Typical High $42.66 | Professional | None | $19.05 | $34.67 | $42.66 |
United Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $1,995.26 | Facility | None | $173.78 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $30.20 Median $63.10 Typical High $107.15 | Professional | None | $30.20 | $63.10 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $46.77 | Professional | None | $38.90 | $39.81 | $46.77 |
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 $11.22 Median $16.60 Typical High $19.50 | Professional | 52 · Reduced service | $11.22 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $6.76 Typical High $7.76 | Professional | 53 · Discontinued | $4.47 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $25.12 Typical High $29.51 | Professional | 54 · Surgery only | $16.98 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.01 Typical High $5.89 | Professional | 55 · Aftercare only | $3.39 | $5.01 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.31 Typical High $3.89 | Professional | 56 · Pre-op care only | $2.24 | $3.31 | $3.89 |
Where Iowa sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 16th of 51
$48.98
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.