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 $602.56 Median $2,630.27 Typical High $6,760.83 | Facility | None | $602.56 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $575.44 Typical High $891.25 | Professional | None | $331.13 | $575.44 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $316.23 | Facility | None | $114.82 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,000.00 | Professional | None | $724.44 | $851.14 | $1,000.00 |
Hally Health Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $758.58 | Professional | None | $331.13 | $549.54 | $758.58 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $794.33 Typical High $1,621.81 | Facility | None | $239.88 | $794.33 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $2,951.21 | Professional | None | $446.68 | $851.14 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,000.00 | Professional | None | $707.95 | $831.76 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $316.23 | Facility | None | $123.03 | $223.87 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,096.48 | Professional | None | $660.69 | $1,000.00 | $1,096.48 |
Oscar Health Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $933.25 | Professional | None | $389.05 | $707.95 | $933.25 |
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 $354.81 Median $537.03 Typical High $1,000.00 | Professional | None | $354.81 | $537.03 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,071.52 | Professional | None | $758.58 | $891.25 | $1,071.52 |
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 $177.83 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $177.83 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $70.79 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $269.15 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $53.70 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $35.48 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $251.19 | $398.11 | $436.52 |
Where Iowa sits
The same service costs 5.1 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
$813
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.