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 $549.54 Median $3,388.44 Typical High $6,760.83 | Facility | None | $549.54 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $549.54 | Professional | None | $257.04 | $416.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $436.52 | Facility | None | $208.93 | $338.84 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $977.24 | Professional | None | $616.60 | $794.33 | $977.24 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $467.74 Typical High $630.96 | Professional | None | $251.19 | $467.74 | $630.96 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $724.44 Typical High $1,621.81 | Facility | None | $309.03 | $724.44 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $707.95 Typical High $1,995.26 | Professional | None | $398.11 | $707.95 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $954.99 | Professional | None | $616.60 | $724.44 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $208.93 Median $316.23 Typical High $436.52 | Facility | None | $208.93 | $316.23 | $436.52 |
Oscar Health Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $758.58 | Professional | None | $245.47 | $446.68 | $758.58 |
United Setting Facility Modifier None Typical Low $223.87 Median $1,096.48 Typical High $2,290.87 | Facility | None | $223.87 | $1,096.48 | $2,290.87 |
United Setting Professional Modifier None Typical Low $309.03 Median $478.63 Typical High $891.25 | Professional | None | $309.03 | $478.63 | $891.25 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $691.83 | Professional | None | $446.68 | $489.78 | $691.83 |
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 $128.82 Median $208.93 Typical High $275.42 | Professional | 52 · Reduced service | $128.82 | $208.93 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $83.18 Typical High $109.65 | Professional | 53 · Discontinued | $52.48 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $316.23 Typical High $407.38 | Professional | 54 · Surgery only | $194.98 | $316.23 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $63.10 Typical High $83.18 | Professional | 55 · Aftercare only | $38.90 | $63.10 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $41.69 Typical High $54.95 | Professional | 56 · Pre-op care only | $26.30 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $295.12 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $181.97 | $295.12 | $380.19 |
Where Iowa sits
The same service costs 4.0 times more in Alaska than in Texas. 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
$550
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.