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 $1,258.93 Median $4,168.69 Typical High $7,244.36 | Facility | None | $1,258.93 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,258.93 Typical High $1,698.24 | Professional | None | $794.33 | $1,258.93 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,238.72 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $1,318.26 Typical High $1,819.70 | Professional | None | $741.31 | $1,318.26 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $2,187.76 Typical High $5,495.41 | Facility | None | $1,096.48 | $2,187.76 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,137.96 Typical High $6,025.60 | Professional | None | $1,202.26 | $2,137.96 | $6,025.60 |
Midlands Setting Professional Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,862.09 | $2,238.72 | $2,691.53 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,698.24 | $2,187.76 |
Oscar Health Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,137.96 | Professional | None | $758.58 | $1,380.38 | $2,137.96 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $2,630.27 | Professional | None | $891.25 | $1,380.38 | $2,630.27 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,548.82 | $1,995.26 |
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 $398.11 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $398.11 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $251.19 Typical High $309.03 | Professional | 53 · Discontinued | $158.49 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $954.99 Typical High $1,148.15 | Professional | 54 · Surgery only | $588.84 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $190.55 Typical High $229.09 | Professional | 55 · Aftercare only | $117.49 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $125.89 Typical High $154.88 | Professional | 56 · Pre-op care only | $79.43 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $891.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $549.54 | $891.25 | $1,071.52 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 4th of 51
$1,820
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.