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 $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $257.04 | Professional | None | $114.82 | $158.49 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $144.54 Typical High $186.21 | Facility | None | $107.15 | $144.54 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | None | $234.42 | $281.84 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $281.84 | Professional | None | $112.20 | $165.96 | $281.84 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $331.13 Typical High $1,380.38 | Facility | None | $154.88 | $331.13 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $933.25 | Professional | None | $138.04 | $275.42 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $338.84 | Professional | None | $239.88 | $281.84 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $141.25 Typical High $186.21 | Facility | None | $107.15 | $141.25 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $338.84 | Professional | None | $229.09 | $323.59 | $338.84 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $295.12 | Professional | None | $125.89 | $229.09 | $295.12 |
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 $120.23 Median $177.83 Typical High $331.13 | Professional | None | $120.23 | $177.83 | $331.13 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $275.42 Typical High $323.59 | Professional | None | $263.03 | $275.42 | $323.59 |
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 $57.54 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $57.54 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $23.44 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $147.91 Typical High $147.91 | Professional | 54 · Surgery only | $87.10 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $17.38 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $11.75 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $138.04 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $81.28 | $138.04 | $138.04 |
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· 4th of 51
$263
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.