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 $229.09 Median $2,630.27 Typical High $6,760.83 | Facility | None | $229.09 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $147.91 Typical High $229.09 | Professional | None | $91.20 | $147.91 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $208.93 | Facility | None | $112.20 | $169.82 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $416.87 | Professional | None | $218.78 | $281.84 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $181.97 Typical High $263.03 | Professional | None | $89.13 | $181.97 | $263.03 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $302.00 Typical High $1,348.96 | Facility | None | $162.18 | $302.00 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $707.95 | Professional | None | $151.36 | $257.04 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $288.40 Typical High $407.38 | Professional | None | $218.78 | $288.40 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $112.20 Median $162.18 Typical High $208.93 | Facility | None | $112.20 | $162.18 | $208.93 |
Oscar Health Setting Professional Modifier None Typical Low $87.10 Median $165.96 Typical High $316.23 | Professional | None | $87.10 | $165.96 | $316.23 |
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 $109.65 Median $181.97 Typical High $363.08 | Professional | None | $109.65 | $181.97 | $363.08 |
Wellmark Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $295.12 | Professional | None | $162.18 | $177.83 | $295.12 |
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 $45.71 Median $74.13 Typical High $114.82 | Professional | 52 · Reduced service | $45.71 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $29.51 Typical High $45.71 | Professional | 53 · Discontinued | $18.20 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $112.20 Typical High $173.78 | Professional | 54 · Surgery only | $69.18 | $112.20 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $22.39 Typical High $34.67 | Professional | 55 · Aftercare only | $13.80 | $22.39 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.79 Typical High $22.91 | Professional | 56 · Pre-op care only | $9.12 | $14.79 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $104.71 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $64.57 | $104.71 | $162.18 |
Where Iowa sits
The same service costs 3.5 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
$219
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.