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 $151.36 Median $2,630.27 Typical High $6,760.83 | Facility | None | $151.36 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $213.80 | Professional | None | $67.61 | $109.65 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $109.65 | Facility | None | $93.33 | $102.33 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $275.42 | Professional | None | $162.18 | $204.17 | $275.42 |
Hally Health Setting Professional Modifier None Typical Low $64.57 Median $125.89 Typical High $177.83 | Professional | None | $64.57 | $125.89 | $177.83 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $1,288.25 | Facility | None | $125.89 | $245.47 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $524.81 | Professional | None | $109.65 | $186.21 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $251.19 | Professional | None | $162.18 | $194.98 | $251.19 |
Midlands Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $117.49 | Facility | None | $93.33 | $102.33 | $117.49 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $199.53 | Professional | None | $63.10 | $117.49 | $199.53 |
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 $77.62 Median $123.03 Typical High $229.09 | Professional | None | $77.62 | $123.03 | $229.09 |
Wellmark Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $190.55 | Professional | None | $117.49 | $131.83 | $190.55 |
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 $33.88 Median $54.95 Typical High $75.86 | Professional | 52 · Reduced service | $33.88 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.88 Typical High $30.20 | Professional | 53 · Discontinued | $13.49 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $81.28 Typical High $114.82 | Professional | 54 · Surgery only | $51.29 | $81.28 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $10.23 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.76 | $10.96 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $75.86 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $47.86 | $75.86 | $107.15 |
Where Iowa sits
The same service costs 3.8 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· 5th of 51
$155
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.