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 $501.19 Median $2,630.27 Typical High $6,760.83 | Facility | None | $501.19 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $776.25 | Professional | None | $295.12 | $501.19 | $776.25 |
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 $645.65 Median $758.58 Typical High $870.96 | Professional | None | $645.65 | $758.58 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $660.69 | Professional | None | $288.40 | $489.78 | $660.69 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $707.95 Typical High $1,621.81 | Facility | None | $239.88 | $707.95 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $758.58 Typical High $2,570.40 | Professional | None | $389.05 | $758.58 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $870.96 | Professional | None | $616.60 | $724.44 | $870.96 |
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 $575.44 Median $870.96 Typical High $933.25 | Professional | None | $575.44 | $870.96 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $338.84 Median $616.60 Typical High $794.33 | Professional | None | $338.84 | $616.60 | $794.33 |
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 $316.23 Median $467.74 Typical High $870.96 | Professional | None | $316.23 | $467.74 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $933.25 | Professional | None | $660.69 | $776.25 | $933.25 |
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 $158.49 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $158.49 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $100.00 Typical High $109.65 | Professional | 53 · Discontinued | $63.10 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $234.42 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $46.77 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $31.62 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $354.81 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $218.78 | $354.81 | $380.19 |
Where Iowa sits
The same service costs 5.9 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
$708
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.