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 $81.28 Median $5,011.87 Typical High $7,943.28 | Facility | None | $81.28 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $239.88 | Professional | None | $64.57 | $162.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $489.78 | Professional | None | $134.90 | $204.17 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $61.66 Median $245.47 Typical High $501.19 | Professional | None | $61.66 | $245.47 | $501.19 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $229.09 Typical High $478.63 | Facility | None | $77.62 | $229.09 | $478.63 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $426.58 Typical High $1,230.27 | Professional | None | $165.96 | $426.58 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $363.08 Typical High $501.19 | Professional | None | $154.88 | $363.08 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $331.13 Typical High $537.03 | Professional | None | $131.83 | $331.13 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $56.23 Median $131.83 Typical High $426.58 | Professional | None | $56.23 | $131.83 | $426.58 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $93.33 | Facility | None | $58.88 | $58.88 | $93.33 |
United Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $501.19 | Professional | None | $85.11 | $194.98 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $346.74 | Professional | None | $79.43 | $97.72 | $346.74 |
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 $33.11 Median $57.54 Typical High $120.23 | Professional | 52 · Reduced service | $33.11 | $57.54 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $22.91 Typical High $47.86 | Professional | 53 · Discontinued | $13.18 | $22.91 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $87.10 Typical High $181.97 | Professional | 54 · Surgery only | $48.98 | $87.10 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $17.38 Typical High $36.31 | Professional | 55 · Aftercare only | $9.77 | $17.38 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $11.48 Typical High $23.99 | Professional | 56 · Pre-op care only | $6.61 | $11.48 | $23.99 |
Where Iowa sits
The same service costs 2.9 times more in Washington than in Kentucky. 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
$240
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.