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 $467.74 Median $3,090.30 Typical High $6,760.83 | Facility | None | $467.74 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $363.08 Typical High $512.86 | Professional | None | $223.87 | $363.08 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | None | $954.99 | $1,230.27 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | None | $537.03 | $630.96 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $588.84 | Professional | None | $218.78 | $416.87 | $588.84 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $933.25 Typical High $4,677.35 | Facility | None | $501.19 | $933.25 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $1,778.28 | Professional | None | $380.19 | $630.96 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $870.96 | Professional | None | $537.03 | $645.65 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,445.44 | Facility | None | $912.01 | $1,230.27 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $724.44 | Professional | None | $223.87 | $407.38 | $724.44 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $812.83 | Professional | None | $263.03 | $416.87 | $812.83 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $676.08 | Professional | None | $407.38 | $446.68 | $676.08 |
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 $114.82 Median $181.97 Typical High $257.04 | Professional | 52 · Reduced service | $114.82 | $181.97 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $102.33 | Professional | 53 · Discontinued | $45.71 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $275.42 Typical High $380.19 | Professional | 54 · Surgery only | $173.78 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $54.95 Typical High $77.62 | Professional | 55 · Aftercare only | $34.67 | $54.95 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $257.04 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $162.18 | $257.04 | $354.81 |
Where Iowa sits
The same service costs 4.0 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
$537
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.