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 $218.78 Median $2,951.21 Typical High $6,760.83 | Facility | None | $218.78 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $331.13 | Professional | None | $107.15 | $169.82 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $186.21 Typical High $245.47 | Facility | None | $158.49 | $186.21 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $416.87 | Professional | None | $245.47 | $323.59 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $281.84 | Professional | None | $100.00 | $190.55 | $281.84 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $407.38 Typical High $2,570.40 | Facility | None | $190.55 | $407.38 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $812.83 | Professional | None | $177.83 | $288.40 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $416.87 | Professional | None | $245.47 | $302.00 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $151.36 Median $186.21 Typical High $245.47 | Facility | None | $151.36 | $186.21 | $245.47 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $194.98 Typical High $331.13 | Professional | None | $107.15 | $194.98 | $331.13 |
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 $123.03 Median $194.98 Typical High $380.19 | Professional | None | $123.03 | $194.98 | $380.19 |
Wellmark Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $316.23 | Professional | None | $194.98 | $218.78 | $316.23 |
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 $52.48 Median $85.11 Typical High $120.23 | Professional | 52 · Reduced service | $52.48 | $85.11 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $33.88 Typical High $48.98 | Professional | 53 · Discontinued | $21.38 | $33.88 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $125.89 Typical High $181.97 | Professional | 54 · Surgery only | $79.43 | $125.89 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.12 Typical High $36.31 | Professional | 55 · Aftercare only | $15.85 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.98 Typical High $24.55 | Professional | 56 · Pre-op care only | $10.47 | $16.98 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $117.49 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $74.13 | $117.49 | $169.82 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 6th of 51
$245
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.