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 $295.12 Median $2,630.27 Typical High $6,760.83 | Facility | None | $295.12 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $190.55 Typical High $295.12 | Professional | None | $117.49 | $190.55 | $295.12 |
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 $275.42 Median $354.81 Typical High $537.03 | Professional | None | $275.42 | $354.81 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $234.42 Typical High $338.84 | Professional | None | $112.20 | $234.42 | $338.84 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $416.87 Typical High $1,288.25 | Facility | None | $251.19 | $416.87 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $912.01 | Professional | None | $186.21 | $323.59 | $912.01 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $524.81 | Professional | None | $275.42 | $371.54 | $524.81 |
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 $112.20 Median $213.80 Typical High $389.05 | Professional | None | $112.20 | $213.80 | $389.05 |
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 $144.54 Median $234.42 Typical High $467.74 | Professional | None | $144.54 | $234.42 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $223.87 Typical High $371.54 | Professional | None | $204.17 | $223.87 | $371.54 |
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 $58.88 Median $95.50 Typical High $147.91 | Professional | 52 · Reduced service | $58.88 | $95.50 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $38.02 Typical High $58.88 | Professional | 53 · Discontinued | $23.44 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $141.25 Typical High $223.87 | Professional | 54 · Surgery only | $89.13 | $141.25 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $28.18 Typical High $44.67 | Professional | 55 · Aftercare only | $17.78 | $28.18 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.05 Typical High $29.51 | Professional | 56 · Pre-op care only | $11.75 | $19.05 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $131.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $83.18 | $131.83 | $208.93 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in Maryland. 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
$275
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.