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 $588.84 Median $3,388.44 Typical High $6,760.83 | Facility | None | $588.84 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $588.84 | Professional | None | $309.03 | $489.78 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $2,454.71 | Facility | None | $954.99 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,000.00 | Professional | None | $691.83 | $870.96 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $691.83 | Professional | None | $295.12 | $512.86 | $691.83 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $1,071.52 Typical High $6,760.83 | Facility | None | $602.56 | $1,071.52 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $794.33 Typical High $2,344.23 | Professional | None | $446.68 | $794.33 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,000.00 | Professional | None | $724.44 | $812.83 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,230.27 | $1,995.26 | $2,454.71 |
Oscar Health Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $851.14 | Professional | None | $309.03 | $562.34 | $851.14 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,762.47 | Facility | None | $1,258.93 | $3,630.78 | $7,762.47 |
United Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $1,023.29 | Professional | None | $354.81 | $501.19 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $794.33 | Professional | None | $562.34 | $616.60 | $794.33 |
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 $154.88 Median $245.47 Typical High $295.12 | Professional | 52 · Reduced service | $154.88 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $61.66 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $371.54 Typical High $446.68 | Professional | 54 · Surgery only | $234.42 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $46.77 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $58.88 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $218.78 | $346.74 | $416.87 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 5th of 51
$708
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.