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 $213.80 Median $2,630.27 Typical High $6,760.83 | Facility | None | $213.80 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $134.90 Typical High $213.80 | Professional | None | $85.11 | $134.90 | $213.80 |
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 $199.53 Median $257.04 Typical High $389.05 | Professional | None | $199.53 | $257.04 | $389.05 |
Hally Health Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $245.47 | Professional | None | $79.43 | $169.82 | $245.47 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $338.84 Typical High $1,380.38 | Facility | None | $194.98 | $338.84 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $229.09 Typical High $645.65 | Professional | None | $134.90 | $229.09 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $380.19 | Professional | None | $199.53 | $269.15 | $380.19 |
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 $79.43 Median $154.88 Typical High $288.40 | Professional | None | $79.43 | $154.88 | $288.40 |
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 $100.00 Median $165.96 Typical High $346.74 | Professional | None | $100.00 | $165.96 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $147.91 Median $165.96 Typical High $275.42 | Professional | None | $147.91 | $165.96 | $275.42 |
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 $41.69 Median $67.61 Typical High $107.15 | Professional | 52 · Reduced service | $41.69 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.92 Typical High $42.66 | Professional | 53 · Discontinued | $16.60 | $26.92 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $102.33 Typical High $162.18 | Professional | 54 · Surgery only | $63.10 | $102.33 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $20.42 Typical High $32.36 | Professional | 55 · Aftercare only | $12.59 | $20.42 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.32 | $13.49 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $95.50 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $58.88 | $95.50 | $151.36 |
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· 5th of 51
$204
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.