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 $147.91 Median $338.84 Typical High $691.83 | Professional | None | $147.91 | $338.84 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,202.26 Typical High $1,548.82 | Facility | None | $645.65 | $1,202.26 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $912.01 | Professional | None | $331.13 | $467.74 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $457.09 Typical High $870.96 | Professional | None | $134.90 | $457.09 | $870.96 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $977.24 Typical High $4,677.35 | Facility | None | $389.05 | $977.24 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $2,818.38 | Professional | None | $323.59 | $741.31 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $660.69 Typical High $851.14 | Professional | None | $281.84 | $660.69 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $724.44 Median $1,230.27 Typical High $1,445.44 | Facility | None | $724.44 | $1,230.27 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $741.31 Typical High $933.25 | Professional | None | $288.40 | $741.31 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $758.58 | Professional | None | $151.36 | $338.84 | $758.58 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $165.96 Median $380.19 Typical High $870.96 | Professional | None | $165.96 | $380.19 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $912.01 | Professional | None | $295.12 | $346.74 | $912.01 |
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 $74.13 Median $147.91 Typical High $269.15 | Professional | 52 · Reduced service | $74.13 | $147.91 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $58.88 Typical High $109.65 | Professional | 53 · Discontinued | $29.51 | $58.88 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $218.78 Typical High $407.38 | Professional | 54 · Surgery only | $109.65 | $218.78 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $43.65 Typical High $81.28 | Professional | 55 · Aftercare only | $21.88 | $43.65 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $29.51 Typical High $54.95 | Professional | 56 · Pre-op care only | $14.79 | $29.51 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $204.17 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $102.33 | $204.17 | $380.19 |
Where Iowa sits
The same service costs 4.0 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
$501
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.