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 $524.81 Median $2,630.27 Typical High $6,760.83 | Facility | None | $524.81 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $575.44 | Professional | None | $263.03 | $426.58 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $436.52 | Facility | None | $208.93 | $346.74 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $912.01 | Professional | None | $630.96 | $776.25 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $630.96 | Professional | None | $251.19 | $467.74 | $630.96 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $758.58 Typical High $1,348.96 | Facility | None | $338.84 | $758.58 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $2,089.30 | Professional | None | $416.87 | $691.83 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $891.25 | Professional | None | $630.96 | $707.95 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $436.52 | Facility | None | $208.93 | $346.74 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $724.44 | Professional | None | $257.04 | $478.63 | $724.44 |
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 $478.63 Typical High $870.96 | Professional | None | $302.00 | $478.63 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $676.08 | Professional | None | $478.63 | $524.81 | $676.08 |
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 $131.83 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $131.83 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $85.11 Typical High $107.15 | Professional | 53 · Discontinued | $53.70 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $323.59 Typical High $398.11 | Professional | 54 · Surgery only | $199.53 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $39.81 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $26.30 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $302.00 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $186.21 | $302.00 | $371.54 |
Where Iowa sits
The same service costs 4.7 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· 5th of 51
$562
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.