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 $208.93 Median $724.44 Typical High $6,309.57 | Facility | None | $208.93 | $724.44 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $371.54 | Professional | None | $97.72 | $208.93 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $371.54 Typical High $467.74 | Facility | None | $107.15 | $371.54 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $691.83 | Professional | None | $208.93 | $316.23 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $95.50 Median $263.03 Typical High $416.87 | Professional | None | $95.50 | $263.03 | $416.87 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $489.78 Typical High $2,290.87 | Facility | None | $229.09 | $489.78 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $316.23 Typical High $954.99 | Professional | None | $173.78 | $316.23 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $436.52 Typical High $630.96 | Professional | None | $208.93 | $436.52 | $630.96 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $363.08 Typical High $467.74 | Facility | None | $107.15 | $363.08 | $467.74 |
Oscar Health Setting Professional Modifier None Typical Low $112.20 Median $251.19 Typical High $549.54 | Professional | None | $112.20 | $251.19 | $549.54 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $117.49 Median $234.42 Typical High $489.78 | Professional | None | $117.49 | $234.42 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $234.42 Typical High $537.03 | Professional | None | $208.93 | $234.42 | $537.03 |
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 $81.28 Typical High $186.21 | Professional | 52 · Reduced service | $51.29 | $81.28 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $32.36 Typical High $74.13 | Professional | 53 · Discontinued | $20.42 | $32.36 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $120.23 Typical High $275.42 | Professional | 54 · Surgery only | $75.86 | $120.23 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $23.99 Typical High $56.23 | Professional | 55 · Aftercare only | $15.14 | $23.99 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.22 Typical High $37.15 | Professional | 56 · Pre-op care only | $10.23 | $16.22 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $112.20 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $70.79 | $112.20 | $257.04 |
Where Iowa sits
The same service costs 4.1 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
$288
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.