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 $112.20 Median $5,011.87 Typical High $7,943.28 | Facility | None | $112.20 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $794.33 | Professional | None | $93.33 | $125.89 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $288.40 Typical High $1,513.56 | Professional | None | $117.49 | $288.40 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $316.23 Typical High $831.76 | Professional | None | $83.18 | $316.23 | $831.76 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $758.58 Typical High $4,897.79 | Facility | None | $223.87 | $758.58 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $812.83 Typical High $4,677.35 | Professional | None | $194.98 | $812.83 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $323.59 Typical High $1,698.24 | Professional | None | $117.49 | $323.59 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $426.58 Typical High $933.25 | Professional | None | $165.96 | $426.58 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $1,513.56 | Professional | None | $83.18 | $190.55 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $5,623.41 Typical High $7,762.47 | Facility | None | $1,995.26 | $5,623.41 | $7,762.47 |
United Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $1,258.93 | Professional | None | $123.03 | $251.19 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $1,698.24 | Professional | None | $151.36 | $186.21 | $1,698.24 |
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 $46.77 Median $63.10 Typical High $389.05 | Professional | 52 · Reduced service | $46.77 | $63.10 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $25.12 Typical High $158.49 | Professional | 53 · Discontinued | $18.62 | $25.12 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $93.33 Typical High $588.84 | Professional | 54 · Surgery only | $70.79 | $93.33 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $19.05 Typical High $117.49 | Professional | 55 · Aftercare only | $14.13 | $19.05 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $12.59 Typical High $79.43 | Professional | 56 · Pre-op care only | $9.33 | $12.59 | $79.43 |
Where Iowa sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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
$603
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.