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 $389.05 Median $2,630.27 Typical High $6,760.83 | Facility | None | $389.05 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $389.05 | Professional | None | $162.18 | $263.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $302.00 Typical High $380.19 | Facility | None | $245.47 | $302.00 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $691.83 | Professional | None | $380.19 | $457.09 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $446.68 | Professional | None | $154.88 | $309.03 | $446.68 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $588.84 Typical High $2,290.87 | Facility | None | $338.84 | $588.84 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $1,258.93 | Professional | None | $275.42 | $446.68 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $660.69 | Professional | None | $380.19 | $478.63 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $380.19 | Facility | None | $245.47 | $288.40 | $380.19 |
Oscar Health Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $524.81 | Professional | None | $154.88 | $288.40 | $524.81 |
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 $186.21 Median $309.03 Typical High $616.60 | Professional | None | $186.21 | $309.03 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $316.23 Typical High $501.19 | Professional | None | $288.40 | $316.23 | $501.19 |
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 $81.28 Median $128.82 Typical High $194.98 | Professional | 52 · Reduced service | $81.28 | $128.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $52.48 Typical High $77.62 | Professional | 53 · Discontinued | $32.36 | $52.48 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $288.40 | Professional | 54 · Surgery only | $123.03 | $194.98 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $57.54 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $26.30 Typical High $38.90 | Professional | 56 · Pre-op care only | $16.22 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $181.97 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $114.82 | $181.97 | $269.15 |
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· 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.