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 $316.23 Median $2,630.27 Typical High $6,760.83 | Facility | None | $316.23 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $204.17 Typical High $398.11 | Professional | None | $125.89 | $204.17 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $229.09 Typical High $309.03 | Facility | None | $114.82 | $229.09 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $575.44 | Professional | None | $295.12 | $380.19 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $251.19 Typical High $363.08 | Professional | None | $120.23 | $251.19 | $363.08 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $416.87 Typical High $1,288.25 | Facility | None | $218.78 | $416.87 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $977.24 | Professional | None | $199.53 | $346.74 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $562.34 | Professional | None | $295.12 | $398.11 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $309.03 | Facility | None | $114.82 | $218.78 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $426.58 | Professional | None | $117.49 | $229.09 | $426.58 |
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 $151.36 Median $251.19 Typical High $501.19 | Professional | None | $151.36 | $251.19 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $239.88 Typical High $398.11 | Professional | None | $218.78 | $239.88 | $398.11 |
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 $63.10 Median $102.33 Typical High $158.49 | Professional | 52 · Reduced service | $63.10 | $102.33 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $40.74 Typical High $63.10 | Professional | 53 · Discontinued | $25.12 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $151.36 Typical High $239.88 | Professional | 54 · Surgery only | $95.50 | $151.36 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $30.20 Typical High $47.86 | Professional | 55 · Aftercare only | $19.05 | $30.20 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.42 Typical High $31.62 | Professional | 56 · Pre-op care only | $12.59 | $20.42 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $141.25 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $89.13 | $141.25 | $223.87 |
Where Iowa sits
The same service costs 3.5 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
$295
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.