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 $776.25 Typical High $6,309.57 | Facility | None | $302.00 | $776.25 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $457.09 | Professional | None | $151.36 | $257.04 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $398.11 | Facility | None | $213.80 | $316.23 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $724.44 | Professional | None | $354.81 | $416.87 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $281.84 Typical High $457.09 | Professional | None | $138.04 | $281.84 | $457.09 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $489.78 Typical High $1,348.96 | Facility | None | $245.47 | $489.78 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $1,122.02 | Professional | None | $229.09 | $407.38 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $660.69 | Professional | None | $354.81 | $478.63 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $398.11 | Facility | None | $213.80 | $309.03 | $398.11 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $537.03 | Professional | None | $144.54 | $275.42 | $537.03 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $588.84 | Professional | None | $169.82 | $295.12 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $512.86 | Professional | None | $263.03 | $295.12 | $512.86 |
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 $117.49 Typical High $199.53 | Professional | 52 · Reduced service | $72.44 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $79.43 | Professional | 53 · Discontinued | $29.51 | $46.77 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $173.78 Typical High $295.12 | Professional | 54 · Surgery only | $109.65 | $173.78 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $34.67 Typical High $58.88 | Professional | 55 · Aftercare only | $21.88 | $34.67 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.44 Typical High $39.81 | Professional | 56 · Pre-op care only | $14.45 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $162.18 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $102.33 | $162.18 | $275.42 |
Where Iowa sits
The same service costs 3.5 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
$355
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.