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 $281.84 Median $2,951.21 Typical High $6,760.83 | Facility | None | $281.84 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $426.58 | Professional | None | $173.78 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | None | $954.99 | $1,230.27 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $630.96 | Professional | None | $416.87 | $478.63 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $416.87 | Professional | None | $165.96 | $302.00 | $416.87 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $724.44 Typical High $4,677.35 | Facility | None | $363.08 | $724.44 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $1,348.96 | Professional | None | $269.15 | $457.09 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $616.60 | Professional | None | $416.87 | $457.09 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,445.44 | Facility | None | $912.01 | $1,230.27 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $524.81 | Professional | None | $177.83 | $331.13 | $524.81 |
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 $199.53 Median $295.12 Typical High $562.34 | Professional | None | $199.53 | $295.12 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $489.78 | Professional | None | $331.13 | $363.08 | $489.78 |
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 $85.11 Median $141.25 Typical High $181.97 | Professional | 52 · Reduced service | $85.11 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $56.23 Typical High $72.44 | Professional | 53 · Discontinued | $34.67 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $208.93 Typical High $275.42 | Professional | 54 · Surgery only | $128.82 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $41.69 Typical High $54.95 | Professional | 55 · Aftercare only | $25.70 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $28.18 Typical High $36.31 | Professional | 56 · Pre-op care only | $17.38 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $194.98 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $120.23 | $194.98 | $257.04 |
Where Iowa sits
The same service costs 4.7 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
$407
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.