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 $275.42 Median $2,630.27 Typical High $6,760.83 | Facility | None | $275.42 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $275.42 | Professional | None | $107.15 | $169.82 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $489.78 | Professional | None | $251.19 | $323.59 | $489.78 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $213.80 Typical High $309.03 | Professional | None | $102.33 | $213.80 | $309.03 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $398.11 Typical High $1,380.38 | Facility | None | $218.78 | $398.11 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $295.12 Typical High $831.76 | Professional | None | $169.82 | $295.12 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $478.63 | Professional | None | $251.19 | $338.84 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Oscar Health Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $363.08 | Professional | None | $100.00 | $194.98 | $363.08 |
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 $128.82 Median $213.80 Typical High $426.58 | Professional | None | $128.82 | $213.80 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $186.21 Median $204.17 Typical High $346.74 | Professional | None | $186.21 | $204.17 | $346.74 |
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 $53.70 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $53.70 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $34.67 Typical High $54.95 | Professional | 53 · Discontinued | $21.38 | $34.67 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $79.43 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.98 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.72 | $16.98 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $120.23 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $74.13 | $120.23 | $190.55 |
Where Iowa sits
The same service costs 3.4 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· 6th of 51
$257
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.