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 $436.52 Median $2,630.27 Typical High $6,760.83 | Facility | None | $436.52 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $478.63 | Professional | None | $218.78 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,445.44 | Facility | None | $630.96 | $1,202.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $776.25 | Professional | None | $512.86 | $602.56 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $371.54 Typical High $501.19 | Professional | None | $208.93 | $371.54 | $501.19 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $724.44 Typical High $3,981.07 | Facility | None | $426.58 | $724.44 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $1,698.24 | Professional | None | $323.59 | $562.34 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $741.31 | Professional | None | $512.86 | $575.44 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,174.90 Typical High $1,445.44 | Facility | None | $645.65 | $1,174.90 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $398.11 Typical High $616.60 | Professional | None | $218.78 | $398.11 | $616.60 |
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 $245.47 Median $371.54 Typical High $724.44 | Professional | None | $245.47 | $371.54 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $575.44 | Professional | None | $398.11 | $436.52 | $575.44 |
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 $109.65 Median $173.78 Typical High $218.78 | Professional | 52 · Reduced service | $109.65 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $43.65 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $165.96 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $33.11 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $21.88 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $154.88 | $245.47 | $302.00 |
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· 4th of 51
$501
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.