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 $234.42 Median $512.86 Typical High $6,309.57 | Facility | None | $234.42 | $512.86 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $354.81 | Professional | None | $112.20 | $177.83 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $208.93 Typical High $275.42 | Facility | None | $177.83 | $208.93 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $446.68 | Professional | None | $263.03 | $338.84 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $208.93 Typical High $302.00 | Professional | None | $104.71 | $208.93 | $302.00 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $436.52 Typical High $2,290.87 | Facility | None | $204.17 | $436.52 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $870.96 | Professional | None | $190.55 | $309.03 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $446.68 | Professional | None | $263.03 | $331.13 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $275.42 | Facility | None | $165.96 | $199.53 | $275.42 |
Oscar Health Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $354.81 | Professional | None | $109.65 | $204.17 | $354.81 |
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 $125.89 Median $204.17 Typical High $398.11 | Professional | None | $125.89 | $204.17 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $338.84 | Professional | None | $204.17 | $223.87 | $338.84 |
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 $56.23 Median $89.13 Typical High $131.83 | Professional | 52 · Reduced service | $56.23 | $89.13 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $35.48 Typical High $52.48 | Professional | 53 · Discontinued | $22.39 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $194.98 | Professional | 54 · Surgery only | $83.18 | $134.90 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $38.90 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $17.78 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.22 | $17.78 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $125.89 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $77.62 | $125.89 | $181.97 |
Where Iowa sits
The same service costs 3.8 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· 4th of 51
$263
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.