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 $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $870.96 | Professional | None | $407.38 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,047.13 Typical High $1,047.13 | Facility | None | $489.78 | $1,047.13 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,230.27 | Professional | None | $912.01 | $1,174.90 | $1,230.27 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,071.52 | Professional | None | $676.08 | $933.25 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,023.29 Typical High $4,168.69 | Facility | None | $630.96 | $1,023.29 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $2,290.87 | Professional | None | $446.68 | $794.33 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,174.90 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,548.82 Typical High $1,548.82 | Professional | None | $912.01 | $1,548.82 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,737.80 | Professional | None | $870.96 | $1,230.27 | $1,737.80 |
United Setting Facility Modifier None Typical Low $524.81 Median $1,288.25 Typical High $2,511.89 | Facility | None | $524.81 | $1,288.25 | $2,511.89 |
United Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $812.83 | Professional | None | $398.11 | $457.09 | $812.83 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
4 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 $204.17 Median $295.12 Typical High $426.58 | Professional | 52 · Reduced service | $204.17 | $295.12 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $117.49 Typical High $173.78 | Professional | 53 · Discontinued | $81.28 | $117.49 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $89.13 Typical High $128.82 | Professional | 55 · Aftercare only | $61.66 | $89.13 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $58.88 Typical High $87.10 | Professional | 56 · Pre-op care only | $40.74 | $58.88 | $87.10 |
Where Iowa sits
The same service costs 3.2 times more in Hawaii than in Delaware. 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· 3rd of 51
$891
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.