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 $316.23 Median $2,290.87 Typical High $6,760.83 | Facility | None | $316.23 | $2,290.87 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $478.63 | Professional | None | $151.36 | $245.47 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $229.09 Typical High $295.12 | Facility | None | $199.53 | $229.09 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $524.81 | Professional | None | $363.08 | $416.87 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $363.08 | Professional | None | $144.54 | $263.03 | $363.08 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $512.86 Typical High $4,677.35 | Facility | None | $257.04 | $512.86 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $1,174.90 | Professional | None | $229.09 | $398.11 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $524.81 | Professional | None | $363.08 | $398.11 | $524.81 |
Midlands Setting Facility Modifier None Typical Low $181.97 Median $223.87 Typical High $295.12 | Facility | None | $181.97 | $223.87 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $446.68 | Professional | None | $154.88 | $281.84 | $446.68 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $489.78 | Professional | None | $173.78 | $257.04 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $416.87 | Professional | None | $288.40 | $316.23 | $416.87 |
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 $75.86 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $75.86 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $30.20 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $112.20 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $22.39 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $104.71 | $169.82 | $218.78 |
Where Iowa sits
The same service costs 4.0 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· 6th of 51
$339
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.