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 $85.11 Median $5,011.87 Typical High $7,943.28 | Facility | None | $85.11 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $85.11 Typical High $112.20 | Professional | None | $58.88 | $85.11 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $58.88 Typical High $72.44 | Facility | None | $48.98 | $58.88 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $165.96 | Professional | None | $63.10 | $128.82 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $151.36 | Professional | None | $43.65 | $79.43 | $151.36 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $147.91 Typical High $1,288.25 | Facility | None | $70.79 | $147.91 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $1,862.09 | Professional | None | $89.13 | $144.54 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $158.49 | Professional | None | $107.15 | $128.82 | $158.49 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $57.54 Typical High $72.44 | Facility | None | $45.71 | $57.54 | $72.44 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Oscar Health Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $128.82 | Professional | None | $41.69 | $77.62 | $128.82 |
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 $57.54 Median $95.50 Typical High $173.78 | Professional | None | $57.54 | $95.50 | $173.78 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $151.36 | Professional | None | $83.18 | $97.72 | $151.36 |
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 $29.51 Median $42.66 Typical High $56.23 | Professional | 52 · Reduced service | $29.51 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.98 Typical High $22.39 | Professional | 53 · Discontinued | $11.75 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $64.57 Typical High $83.18 | Professional | 54 · Surgery only | $44.67 | $64.57 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $12.88 Typical High $16.60 | Professional | 55 · Aftercare only | $8.91 | $12.88 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.51 Typical High $11.22 | Professional | 56 · Pre-op care only | $5.89 | $8.51 | $11.22 |
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· 4th of 51
$123
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.