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 $512.86 Median $2,630.27 Typical High $6,760.83 | Facility | None | $512.86 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $776.25 | Professional | None | $275.42 | $467.74 | $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 $602.56 Median $707.95 Typical High $812.83 | Professional | None | $602.56 | $707.95 | $812.83 |
Hally Health Setting Professional Modifier None Typical Low $269.15 Median $457.09 Typical High $630.96 | Professional | None | $269.15 | $457.09 | $630.96 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $660.69 Typical High $1,621.81 | Facility | None | $239.88 | $660.69 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $707.95 Typical High $2,398.83 | Professional | None | $371.54 | $707.95 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $812.83 | Professional | None | $575.44 | $676.08 | $812.83 |
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 $549.54 Median $812.83 Typical High $891.25 | Professional | None | $549.54 | $812.83 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $575.44 Typical High $741.31 | Professional | None | $316.23 | $575.44 | $741.31 |
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 $295.12 Median $446.68 Typical High $831.76 | Professional | None | $295.12 | $446.68 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $851.14 | Professional | None | $616.60 | $724.44 | $851.14 |
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 $144.54 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $144.54 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $58.88 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $218.78 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $43.65 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $29.51 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $204.17 | $331.13 | $354.81 |
Where Iowa sits
The same service costs 5.5 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
$661
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.