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 $478.63 Median $2,630.27 Typical High $6,760.83 | Facility | None | $478.63 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $676.08 | Professional | None | $251.19 | $426.58 | $676.08 |
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 $537.03 Median $645.65 Typical High $758.58 | Professional | None | $537.03 | $645.65 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $524.81 | Professional | None | $245.47 | $389.05 | $524.81 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $602.56 Typical High $1,348.96 | Facility | None | $223.87 | $602.56 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $2,238.72 | Professional | None | $323.59 | $645.65 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $741.31 | Professional | None | $512.86 | $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 $467.74 Median $741.31 Typical High $831.76 | Professional | None | $467.74 | $741.31 | $831.76 |
Oscar Health Setting Professional Modifier None Typical Low $295.12 Median $537.03 Typical High $707.95 | Professional | None | $295.12 | $537.03 | $707.95 |
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 $251.19 Median $389.05 Typical High $724.44 | Professional | None | $251.19 | $389.05 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $812.83 | Professional | None | $575.44 | $676.08 | $812.83 |
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 $131.83 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $131.83 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $85.11 Typical High $95.50 | Professional | 53 · Discontinued | $53.70 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $316.23 Typical High $354.81 | Professional | 54 · Surgery only | $199.53 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $39.81 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $186.21 | $302.00 | $331.13 |
Where Iowa sits
The same service costs 5.4 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.