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 $194.98 Median $2,630.27 Typical High $6,760.83 | Facility | None | $194.98 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $194.98 | Professional | None | $102.33 | $169.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $177.83 | Facility | None | $107.15 | $138.04 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $302.00 | Professional | None | $218.78 | $257.04 | $302.00 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $229.09 | Professional | None | $97.72 | $158.49 | $229.09 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $281.84 Typical High $1,288.25 | Facility | None | $151.36 | $281.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $891.25 | Professional | None | $134.90 | $269.15 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $281.84 | Professional | None | $204.17 | $245.47 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $177.83 | Facility | None | $107.15 | $138.04 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $323.59 | Professional | None | $194.98 | $281.84 | $323.59 |
Oscar Health Setting Professional Modifier None Typical Low $107.15 Median $204.17 Typical High $257.04 | Professional | None | $107.15 | $204.17 | $257.04 |
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 $104.71 Median $165.96 Typical High $309.03 | Professional | None | $104.71 | $165.96 | $309.03 |
Wellmark Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $302.00 | Professional | None | $213.80 | $251.19 | $302.00 |
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 $53.70 Median $85.11 Typical High $97.72 | Professional | 52 · Reduced service | $53.70 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $33.88 Typical High $38.90 | Professional | 53 · Discontinued | $21.38 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $128.82 Typical High $144.54 | Professional | 54 · Surgery only | $79.43 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $25.70 Typical High $28.84 | Professional | 55 · Aftercare only | $15.85 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $16.98 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.72 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $120.23 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $74.13 | $120.23 | $134.90 |
Where Iowa sits
The same service costs 4.5 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· 4th of 51
$240
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.