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 $354.81 Median $2,630.27 Typical High $6,760.83 | Facility | None | $354.81 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $512.86 | Professional | None | $194.98 | $338.84 | $512.86 |
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 $426.58 Median $501.19 Typical High $575.44 | Professional | None | $426.58 | $501.19 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $436.52 | Professional | None | $190.55 | $316.23 | $436.52 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $524.81 Typical High $1,348.96 | Facility | None | $223.87 | $524.81 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $1,659.59 | Professional | None | $257.04 | $501.19 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $575.44 | Professional | None | $407.38 | $478.63 | $575.44 |
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 $363.08 Median $575.44 Typical High $616.60 | Professional | None | $363.08 | $575.44 | $616.60 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $501.19 | Professional | None | $218.78 | $407.38 | $501.19 |
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 $204.17 Median $309.03 Typical High $575.44 | Professional | None | $204.17 | $309.03 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $588.84 | Professional | None | $436.52 | $489.78 | $588.84 |
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 $104.71 Median $165.96 Typical High $177.83 | Professional | 52 · Reduced service | $104.71 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $67.61 Typical High $70.79 | Professional | 53 · Discontinued | $41.69 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $251.19 Typical High $263.03 | Professional | 54 · Surgery only | $154.88 | $251.19 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $50.12 Typical High $53.70 | Professional | 55 · Aftercare only | $30.90 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.88 Typical High $35.48 | Professional | 56 · Pre-op care only | $20.89 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $234.42 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $144.54 | $234.42 | $245.47 |
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· 3rd of 51
$468
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.