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 $302.00 Median $2,290.87 Typical High $6,760.83 | Facility | None | $302.00 | $2,290.87 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $346.74 | Professional | None | $144.54 | $229.09 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $275.42 Typical High $354.81 | Facility | None | $229.09 | $275.42 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $588.84 | Professional | None | $338.84 | $407.38 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $398.11 | Professional | None | $138.04 | $275.42 | $398.11 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $537.03 Typical High $2,290.87 | Facility | None | $269.15 | $537.03 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $389.05 Typical High $1,122.02 | Professional | None | $234.42 | $389.05 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $588.84 | Professional | None | $338.84 | $436.52 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $354.81 | Facility | None | $223.87 | $269.15 | $354.81 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $478.63 | Professional | None | $141.25 | $257.04 | $478.63 |
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 $275.42 Typical High $562.34 | Professional | None | $162.18 | $275.42 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $457.09 | Professional | None | $257.04 | $288.40 | $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 $72.44 Median $114.82 Typical High $173.78 | Professional | 52 · Reduced service | $72.44 | $114.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $45.71 Typical High $69.18 | Professional | 53 · Discontinued | $28.84 | $45.71 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $173.78 Typical High $263.03 | Professional | 54 · Surgery only | $107.15 | $173.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $34.67 Typical High $52.48 | Professional | 55 · Aftercare only | $21.88 | $34.67 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.91 Typical High $34.67 | Professional | 56 · Pre-op care only | $14.45 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $162.18 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $100.00 | $162.18 | $245.47 |
Where Iowa sits
The same service costs 3.4 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· 7th of 51
$347
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.