How much rates vary
Facilitymedian $427 · 10th to 90th $407 to $479Professionalmedian $437 · 10th to 90th $380 to $1,096
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 $407.38 Median $478.63 Typical High $588.84 | Facility | None | $407.38 | $478.63 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | None | $416.87 | $426.58 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $933.25 | Professional | None | $269.15 | $426.58 | $933.25 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $436.52 Typical High $562.34 | Facility | None | $380.19 | $436.52 | $562.34 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $1,584.89 | Professional | None | $380.19 | $436.52 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $575.44 | Professional | None | $457.09 | $467.74 | $575.44 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $831.76 | Professional | None | $457.09 | $602.56 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $831.76 | Professional | None | $426.58 | $691.83 | $831.76 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $467.74 | Professional | None | $389.05 | $407.38 | $467.74 |
Wellmark Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
8 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 Facility Modifier 52 · Reduced service Typical Low $204.17 Median $234.42 Typical High $295.12 | Facility | 52 · Reduced service | $204.17 | $234.42 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $81.28 Median $95.50 Typical High $117.49 | Facility | 53 · Discontinued | $81.28 | $95.50 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $89.13 | Facility | 55 · Aftercare only | $61.66 | $70.79 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $58.88 | Facility | 56 · Pre-op care only | $40.74 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $47.86 |
Where Iowa sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 10th of 51
$427
AK $589OK $389
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.