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 $537.03 Median $1,258.93 Typical High $6,606.93 | Facility | None | $537.03 | $1,258.93 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $645.65 | Professional | None | $251.19 | $398.11 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $436.52 Typical High $602.56 | Facility | None | $245.47 | $436.52 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,174.90 | Professional | None | $575.44 | $741.31 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $512.86 Typical High $741.31 | Professional | None | $234.42 | $512.86 | $741.31 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $1,819.70 | Facility | None | $457.09 | $741.31 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $1,905.46 | Professional | None | $426.58 | $707.95 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,174.90 | Professional | None | $575.44 | $812.83 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $602.56 | Facility | None | $269.15 | $407.38 | $602.56 |
Oscar Health Setting Professional Modifier None Typical Low $234.42 Median $446.68 Typical High $870.96 | Professional | None | $234.42 | $446.68 | $870.96 |
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 $302.00 Median $524.81 Typical High $1,071.52 | Professional | None | $302.00 | $524.81 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $831.76 | Professional | None | $426.58 | $478.63 | $831.76 |
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 $125.89 Median $199.53 Typical High $323.59 | Professional | 52 · Reduced service | $125.89 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $79.43 Typical High $128.82 | Professional | 53 · Discontinued | $50.12 | $79.43 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $295.12 Typical High $478.63 | Professional | 54 · Surgery only | $186.21 | $295.12 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $58.88 Typical High $95.50 | Professional | 55 · Aftercare only | $37.15 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $39.81 Typical High $64.57 | Professional | 56 · Pre-op care only | $25.12 | $39.81 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $275.42 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $173.78 | $275.42 | $446.68 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$617
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.