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 $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $630.96 | Professional | None | $257.04 | $407.38 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $562.34 | Facility | None | $363.08 | $457.09 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $912.01 | Professional | None | $575.44 | $707.95 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $234.42 Median $501.19 Typical High $645.65 | Professional | None | $234.42 | $501.19 | $645.65 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $1,023.29 Typical High $5,248.07 | Facility | None | $501.19 | $1,023.29 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $2,884.03 | Professional | None | $457.09 | $776.25 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $912.01 | Professional | None | $489.78 | $724.44 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $354.81 Median $426.58 Typical High $562.34 | Facility | None | $354.81 | $426.58 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,047.13 | Professional | None | $489.78 | $794.33 | $1,047.13 |
Oscar Health Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $794.33 | Professional | None | $257.04 | $478.63 | $794.33 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,309.57 | Facility | None | $1,258.93 | $3,235.94 | $6,309.57 |
United Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $933.25 | Professional | None | $295.12 | $489.78 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $933.25 | Professional | None | $501.19 | $588.84 | $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 $128.82 Median $204.17 Typical High $302.00 | Professional | 52 · Reduced service | $128.82 | $204.17 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $81.28 Typical High $120.23 | Professional | 53 · Discontinued | $51.29 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $309.03 Typical High $446.68 | Professional | 54 · Surgery only | $194.98 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $61.66 Typical High $89.13 | Professional | 55 · Aftercare only | $38.90 | $61.66 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $40.74 Typical High $60.26 | Professional | 56 · Pre-op care only | $25.70 | $40.74 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $288.40 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $181.97 | $288.40 | $416.87 |
Where Iowa sits
The same service costs 4.3 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· 5th of 51
$676
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.