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 $398.11 Median $2,630.27 Typical High $6,760.83 | Facility | None | $398.11 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $398.11 | Professional | None | $229.09 | $389.05 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,445.44 Typical High $1,698.24 | Facility | None | $389.05 | $1,445.44 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $676.08 | Professional | None | $446.68 | $549.54 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $446.68 | Professional | None | $223.87 | $323.59 | $446.68 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $660.69 Typical High $4,786.30 | Facility | None | $389.05 | $660.69 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $537.03 Typical High $1,862.09 | Professional | None | $269.15 | $537.03 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $660.69 | Professional | None | $467.74 | $524.81 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $416.87 Median $1,412.54 Typical High $1,698.24 | Facility | None | $416.87 | $1,412.54 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $676.08 | Professional | None | $436.52 | $660.69 | $676.08 |
Oscar Health Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $588.84 | Professional | None | $263.03 | $467.74 | $588.84 |
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 $234.42 Median $338.84 Typical High $630.96 | Professional | None | $234.42 | $338.84 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $660.69 | Professional | None | $512.86 | $562.34 | $660.69 |
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 $114.82 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $114.82 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $45.71 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $173.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $34.67 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.91 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $162.18 | $275.42 | $275.42 |
Where Iowa sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 4th of 51
$537
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.