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 $131.83 Median $213.80 Typical High $316.23 | Professional | None | $131.83 | $213.80 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $208.93 Typical High $263.03 | Facility | None | $165.96 | $208.93 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $562.34 | Professional | None | $309.03 | $389.05 | $562.34 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $363.08 | Professional | None | $125.89 | $251.19 | $363.08 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,348.96 | Facility | None | $208.93 | $398.11 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $1,023.29 | Professional | None | $208.93 | $363.08 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $549.54 | Professional | None | $309.03 | $389.05 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $263.03 | Facility | None | $165.96 | $199.53 | $263.03 |
Oscar Health Setting Professional Modifier None Typical Low $123.03 Median $229.09 Typical High $416.87 | Professional | None | $123.03 | $229.09 | $416.87 |
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 $158.49 Median $251.19 Typical High $501.19 | Professional | None | $158.49 | $251.19 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $398.11 | Professional | None | $223.87 | $251.19 | $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 $66.07 Median $104.71 Typical High $158.49 | Professional | 52 · Reduced service | $66.07 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $42.66 Typical High $63.10 | Professional | 53 · Discontinued | $26.30 | $42.66 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $158.49 Typical High $234.42 | Professional | 54 · Surgery only | $97.72 | $158.49 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $31.62 Typical High $46.77 | Professional | 55 · Aftercare only | $19.95 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.38 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.18 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $147.91 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $91.20 | $147.91 | $218.78 |
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
$309
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.