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 $354.81 Median $2,630.27 Typical High $6,760.83 | Facility | None | $354.81 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $630.96 | Professional | None | $204.17 | $323.59 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $331.13 Typical High $416.87 | Facility | None | $275.42 | $331.13 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $812.83 | Professional | None | $467.74 | $602.56 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $524.81 | Professional | None | $190.55 | $363.08 | $524.81 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $645.65 Typical High $3,981.07 | Facility | None | $354.81 | $645.65 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $1,548.82 | Professional | None | $331.13 | $549.54 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $758.58 | Professional | None | $467.74 | $562.34 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $316.23 Typical High $416.87 | Facility | None | $269.15 | $316.23 | $416.87 |
Oscar Health Setting Professional Modifier None Typical Low $194.98 Median $354.81 Typical High $630.96 | Professional | None | $194.98 | $354.81 | $630.96 |
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 $229.09 Median $363.08 Typical High $724.44 | Professional | None | $229.09 | $363.08 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $588.84 | Professional | None | $354.81 | $389.05 | $588.84 |
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 $102.33 Median $162.18 Typical High $223.87 | Professional | 52 · Reduced service | $102.33 | $162.18 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $91.20 | Professional | 53 · Discontinued | $40.74 | $64.57 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $338.84 | Professional | 54 · Surgery only | $151.36 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $67.61 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $44.67 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $316.23 |
Where Iowa sits
The same service costs 3.9 times more in Alaska than in Texas. 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
$457
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.