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 $295.12 Median $2,630.27 Typical High $6,760.83 | Facility | None | $295.12 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $295.12 | Professional | None | $154.88 | $245.47 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $281.84 | Facility | None | $114.82 | $213.80 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $467.74 | Professional | None | $331.13 | $371.54 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $239.88 Typical High $346.74 | Professional | None | $141.25 | $239.88 | $346.74 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $416.87 Typical High $1,348.96 | Facility | None | $213.80 | $416.87 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $1,380.38 | Professional | None | $204.17 | $389.05 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $416.87 | Professional | None | $302.00 | $354.81 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $213.80 Typical High $281.84 | Facility | None | $114.82 | $213.80 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $501.19 | Professional | None | $288.40 | $416.87 | $501.19 |
Oscar Health Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $407.38 | Professional | None | $162.18 | $302.00 | $407.38 |
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 $162.18 Median $245.47 Typical High $457.09 | Professional | None | $162.18 | $245.47 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $478.63 | Professional | None | $323.59 | $380.19 | $478.63 |
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 $77.62 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $77.62 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $30.90 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $114.82 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $23.44 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.49 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $107.15 | $173.78 | $208.93 |
Where Iowa sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$355
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.