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 $2,951.21 Typical High $6,760.83 | Facility | None | $588.84 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $588.84 | Professional | None | $263.03 | $426.58 | $588.84 |
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 $630.96 Median $776.25 Typical High $1,000.00 | Professional | None | $630.96 | $776.25 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $257.04 Median $489.78 Typical High $691.83 | Professional | None | $257.04 | $489.78 | $691.83 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,023.29 Typical High $4,677.35 | Facility | None | $616.60 | $1,023.29 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $741.31 Typical High $2,089.30 | Professional | None | $446.68 | $741.31 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,000.00 | Professional | None | $630.96 | $741.31 | $1,000.00 |
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 $263.03 Median $478.63 Typical High $831.76 | Professional | None | $263.03 | $478.63 | $831.76 |
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 $323.59 Median $501.19 Typical High $954.99 | Professional | None | $323.59 | $501.19 | $954.99 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $776.25 | Professional | None | $478.63 | $524.81 | $776.25 |
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 $138.04 Median $213.80 Typical High $295.12 | Professional | 52 · Reduced service | $138.04 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $85.11 Typical High $117.49 | Professional | 53 · Discontinued | $54.95 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $323.59 Typical High $446.68 | Professional | 54 · Surgery only | $204.17 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $64.57 Typical High $89.13 | Professional | 55 · Aftercare only | $40.74 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $42.66 Typical High $58.88 | Professional | 56 · Pre-op care only | $27.54 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $302.00 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $190.55 | $302.00 | $416.87 |
Where Iowa sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$631
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.