How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $3,388.44 Median $3,388.44 Typical High $13,182.57 | Facility | None | $3,388.44 | $3,388.44 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,715.35 | Professional | None | $3,388.44 | $3,388.44 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,467.37 | $3,548.13 | $3,548.13 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $2,884.03 Typical High $3,388.44 | Professional | None | $151.36 | $2,884.03 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $15,135.61 | Facility | None | $1,288.25 | $4,073.80 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $15,488.17 | Professional | None | $3,388.44 | $3,388.44 | $15,488.17 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,467.37 | Professional | None | $3,388.44 | $3,388.44 | $3,467.37 |
Oscar Health Setting Professional Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $7,244.36 | Professional | None | $5,370.32 | $6,165.95 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,890.45 | Professional | None | $3,467.37 | $3,467.37 | $3,890.45 |
Wellmark Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
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 $1,698.24 Median $1,698.24 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $707.95 | Professional | 53 · Discontinued | $676.08 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $537.03 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $354.81 |
Where Iowa sits
The same service costs 1.6 times more in North Carolina than in Nebraska. 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· 50th of 51
$3,467
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.