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 $575.44 Median $3,388.44 Typical High $6,760.83 | Facility | None | $575.44 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $575.44 | Professional | None | $213.80 | $338.84 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $363.08 Typical High $954.99 | Facility | None | $91.20 | $363.08 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,071.52 | Professional | None | $501.19 | $630.96 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $446.68 Typical High $660.69 | Professional | None | $204.17 | $446.68 | $660.69 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $630.96 Typical High $1,621.81 | Facility | None | $389.05 | $630.96 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $1,621.81 | Professional | None | $371.54 | $588.84 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,023.29 | Professional | None | $501.19 | $724.44 | $1,023.29 |
Midlands Setting Facility Modifier None Typical Low $97.72 Median $371.54 Typical High $524.81 | Facility | None | $97.72 | $371.54 | $524.81 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $416.87 Typical High $831.76 | Professional | None | $218.78 | $416.87 | $831.76 |
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 $251.19 Median $436.52 Typical High $891.25 | Professional | None | $251.19 | $436.52 | $891.25 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $776.25 | Professional | None | $389.05 | $436.52 | $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 $107.15 Median $169.82 Typical High $288.40 | Professional | 52 · Reduced service | $107.15 | $169.82 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $67.61 Typical High $114.82 | Professional | 53 · Discontinued | $42.66 | $67.61 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $251.19 Typical High $436.52 | Professional | 54 · Surgery only | $158.49 | $251.19 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $50.12 Typical High $87.10 | Professional | 55 · Aftercare only | $31.62 | $50.12 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $33.88 Typical High $57.54 | Professional | 56 · Pre-op care only | $21.38 | $33.88 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $234.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $147.91 | $234.42 | $407.38 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$513
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.