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 $95.50 Median $602.56 Typical High $6,606.93 | Facility | None | $95.50 | $602.56 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $138.04 | Professional | None | $52.48 | $85.11 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $70.79 | Facility | None | $61.66 | $66.07 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $173.78 | Professional | None | $123.03 | $144.54 | $173.78 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $131.83 | Professional | None | $50.12 | $89.13 | $131.83 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $169.82 Typical High $1,380.38 | Facility | None | $95.50 | $169.82 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $416.87 | Professional | None | $74.13 | $138.04 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $173.78 | Professional | None | $123.03 | $141.25 | $173.78 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
Oscar Health Setting Professional Modifier None Typical Low $50.12 Median $93.33 Typical High $138.04 | Professional | None | $50.12 | $93.33 | $138.04 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $58.88 Median $91.20 Typical High $181.97 | Professional | None | $58.88 | $91.20 | $181.97 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $131.83 | Professional | None | $95.50 | $104.71 | $131.83 |
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 $26.30 Median $42.66 Typical High $52.48 | Professional | 52 · Reduced service | $26.30 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.98 Typical High $20.89 | Professional | 53 · Discontinued | $10.47 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $63.10 Typical High $77.62 | Professional | 54 · Surgery only | $39.81 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $7.94 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.51 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.25 | $8.51 | $10.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $37.15 Median $58.88 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $37.15 | $58.88 | $72.44 |
Where Iowa sits
The same service costs 4.2 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· 7th of 51
$112
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.