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 $426.58 Median $2,630.27 Typical High $6,760.83 | Facility | None | $426.58 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $602.56 | Professional | None | $234.42 | $371.54 | $602.56 |
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 $501.19 Median $602.56 Typical High $676.08 | Professional | None | $501.19 | $602.56 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $549.54 | Professional | None | $213.80 | $380.19 | $549.54 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $588.84 Typical High $1,348.96 | Facility | None | $223.87 | $588.84 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $1,995.26 | Professional | None | $316.23 | $588.84 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $630.96 | Professional | None | $457.09 | $537.03 | $630.96 |
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 $446.68 Median $630.96 Typical High $724.44 | Professional | None | $446.68 | $630.96 | $724.44 |
Oscar Health Setting Professional Modifier None Typical Low $239.88 Median $446.68 Typical High $588.84 | Professional | None | $239.88 | $446.68 | $588.84 |
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 $239.88 Median $371.54 Typical High $691.83 | Professional | None | $239.88 | $371.54 | $691.83 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $676.08 | Professional | None | $467.74 | $549.54 | $676.08 |
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 $117.49 Median $186.21 Typical High $213.80 | Professional | 52 · Reduced service | $117.49 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $74.13 Typical High $85.11 | Professional | 53 · Discontinued | $46.77 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $177.83 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $56.23 Typical High $63.10 | Professional | 55 · Aftercare only | $35.48 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $37.15 Typical High $42.66 | Professional | 56 · Pre-op care only | $23.44 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $263.03 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $165.96 | $263.03 | $295.12 |
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
$537
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.