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 $446.68 Median $2,630.27 Typical High $6,760.83 | Facility | None | $446.68 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $446.68 | Professional | None | $251.19 | $426.58 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $281.84 | Facility | None | $114.82 | $218.78 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $741.31 | Professional | None | $512.86 | $616.60 | $741.31 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $524.81 | Professional | None | $245.47 | $380.19 | $524.81 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $602.56 Typical High $1,513.56 | Facility | None | $223.87 | $602.56 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $602.56 Typical High $2,089.30 | Professional | None | $309.03 | $602.56 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $741.31 | Professional | None | $524.81 | $602.56 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $281.84 | Facility | None | $114.82 | $218.78 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $776.25 | Professional | None | $489.78 | $741.31 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $524.81 Typical High $660.69 | Professional | None | $288.40 | $524.81 | $660.69 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $707.95 | Professional | None | $257.04 | $389.05 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $758.58 | Professional | None | $562.34 | $645.65 | $758.58 |
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 $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $128.82 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $85.11 Typical High $89.13 | Professional | 53 · Discontinued | $52.48 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $194.98 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $38.90 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $26.30 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $181.97 | $295.12 | $309.03 |
Where Iowa sits
The same service costs 5.9 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· 4th of 51
$589
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.