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 $295.12 Median $2,238.72 Typical High $6,760.83 | Facility | None | $295.12 | $2,238.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $229.09 Typical High $446.68 | Professional | None | $141.25 | $229.09 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $229.09 Typical High $295.12 | Facility | None | $194.98 | $229.09 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $501.19 | Professional | None | $331.13 | $389.05 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $239.88 Typical High $338.84 | Professional | None | $134.90 | $239.88 | $338.84 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $489.78 Typical High $2,691.53 | Facility | None | $229.09 | $489.78 | $2,691.53 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $1,096.48 | Professional | None | $213.80 | $371.54 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $501.19 | Professional | None | $331.13 | $380.19 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $181.97 Median $218.78 Typical High $295.12 | Facility | None | $181.97 | $218.78 | $295.12 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $407.38 | Professional | None | $141.25 | $263.03 | $407.38 |
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 $162.18 Median $239.88 Typical High $457.09 | Professional | None | $162.18 | $239.88 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $389.05 | Professional | None | $263.03 | $288.40 | $389.05 |
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 $70.79 Median $114.82 Typical High $147.91 | Professional | 52 · Reduced service | $70.79 | $114.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $45.71 Typical High $58.88 | Professional | 53 · Discontinued | $28.18 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $169.82 Typical High $218.78 | Professional | 54 · Surgery only | $107.15 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.88 Typical High $44.67 | Professional | 55 · Aftercare only | $21.38 | $33.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $22.91 Typical High $29.51 | Professional | 56 · Pre-op care only | $14.13 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $158.49 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $100.00 | $158.49 | $204.17 |
Where Iowa sits
The same service costs 3.9 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
$316
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.