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 $275.42 Median $2,238.72 Typical High $6,606.93 | Facility | None | $275.42 | $2,238.72 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $275.42 Typical High $524.81 | Professional | None | $177.83 | $275.42 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $251.19 Typical High $323.59 | Facility | None | $213.80 | $251.19 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $588.84 | Professional | None | $407.38 | $478.63 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $398.11 | Professional | None | $165.96 | $295.12 | $398.11 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $524.81 Typical High $3,981.07 | Facility | None | $288.40 | $524.81 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $1,348.96 | Professional | None | $257.04 | $446.68 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $588.84 | Professional | None | $407.38 | $457.09 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $323.59 | Facility | None | $199.53 | $245.47 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $489.78 | Professional | None | $169.82 | $316.23 | $489.78 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $562.34 | Professional | None | $194.98 | $288.40 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $457.09 | Professional | None | $316.23 | $354.81 | $457.09 |
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 $87.10 Median $138.04 Typical High $173.78 | Professional | 52 · Reduced service | $87.10 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $54.95 Typical High $69.18 | Professional | 53 · Discontinued | $34.67 | $54.95 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $208.93 Typical High $263.03 | Professional | 54 · Surgery only | $128.82 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $41.69 Typical High $52.48 | Professional | 55 · Aftercare only | $25.70 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $27.54 Typical High $34.67 | Professional | 56 · Pre-op care only | $17.38 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $194.98 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $120.23 | $194.98 | $245.47 |
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
$380
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.