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 $154.88 Median $5,888.44 Typical High $7,943.28 | Facility | None | $154.88 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $199.53 | Professional | None | $138.04 | $154.88 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $363.08 | Professional | None | $204.17 | $288.40 | $363.08 |
Hally Health Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $229.09 | Professional | None | $109.65 | $144.54 | $229.09 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $363.08 Typical High $1,380.38 | Facility | None | $120.23 | $363.08 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $257.04 Typical High $389.05 | Professional | None | $95.50 | $257.04 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $389.05 | Professional | None | $263.03 | $275.42 | $389.05 |
Oscar Health Setting Professional Modifier None Typical Low $120.23 Median $229.09 Typical High $275.42 | Professional | None | $120.23 | $229.09 | $275.42 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $346.74 | Professional | None | $120.23 | $194.98 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $223.87 | Professional | None | $190.55 | $223.87 | $223.87 |
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 $67.61 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $27.54 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 54 · Surgery only | $102.33 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.44 Typical High $23.44 | Professional | 55 · Aftercare only | $20.42 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.80 | $15.49 | $15.49 |
Where Iowa sits
The same service costs 3.2 times more in Alaska 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· 6th of 51
$251
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.