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 $79.43 Median $5,011.87 Typical High $7,943.28 | Facility | None | $79.43 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $104.71 Typical High $177.83 | Professional | None | $50.12 | $104.71 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Facility | None | $61.66 | $61.66 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $162.18 Typical High $323.59 | Professional | None | $117.49 | $162.18 | $323.59 |
Hally Health Setting Professional Modifier None Typical Low $47.86 Median $138.04 Typical High $199.53 | Professional | None | $47.86 | $138.04 | $199.53 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $275.42 Typical High $1,288.25 | Facility | None | $120.23 | $275.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $165.96 Typical High $436.52 | Professional | None | $114.82 | $165.96 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $302.00 | Professional | None | $117.49 | $218.78 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $234.42 | Professional | None | $45.71 | $102.33 | $234.42 |
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 $61.66 Median $123.03 Typical High $257.04 | Professional | None | $61.66 | $123.03 | $257.04 |
Wellmark Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $223.87 | Professional | None | $85.11 | $93.33 | $223.87 |
6 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 $25.12 Median $39.81 Typical High $89.13 | Professional | 52 · Reduced service | $25.12 | $39.81 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.85 Typical High $35.48 | Professional | 53 · Discontinued | $10.00 | $15.85 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $60.26 Typical High $131.83 | Professional | 54 · Surgery only | $38.02 | $60.26 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $12.02 Typical High $26.30 | Professional | 55 · Aftercare only | $7.59 | $12.02 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.94 Typical High $17.78 | Professional | 56 · Pre-op care only | $5.01 | $7.94 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $56.23 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $35.48 | $56.23 | $123.03 |
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· 8th of 51
$141
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.