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 $165.96 Median $323.59 Typical High $5,888.44 | Facility | None | $165.96 | $323.59 | $5,888.44 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $263.03 | Professional | None | $102.33 | $165.96 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $177.83 | Facility | None | $100.00 | $141.25 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $346.74 | Professional | None | $208.93 | $275.42 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $257.04 | Professional | None | $97.72 | $151.36 | $257.04 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $281.84 Typical High $1,348.96 | Facility | None | $134.90 | $281.84 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $794.33 | Professional | None | $138.04 | $263.03 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $323.59 | Professional | None | $229.09 | $275.42 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $177.83 | Facility | None | $100.00 | $141.25 | $177.83 |
Oscar Health Setting Facility Modifier None Typical Low $457.09 Median $1,412.54 Typical High $2,454.71 | Facility | None | $457.09 | $1,412.54 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $269.15 | Professional | None | $107.15 | $199.53 | $269.15 |
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 $109.65 Median $154.88 Typical High $316.23 | Professional | None | $109.65 | $154.88 | $316.23 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $257.04 | Professional | None | $199.53 | $223.87 | $257.04 |
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 $51.29 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $51.29 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $20.42 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $75.86 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $15.14 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.23 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $114.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $70.79 | $114.82 | $138.04 |
Where Iowa sits
The same service costs 4.4 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· 7th of 51
$219
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.