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 $389.05 Median $2,630.27 Typical High $6,760.83 | Facility | None | $389.05 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $389.05 | Professional | None | $204.17 | $323.59 | $389.05 |
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 $363.08 Median $467.74 Typical High $602.56 | Professional | None | $363.08 | $467.74 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $389.05 | Professional | None | $186.21 | $257.04 | $389.05 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $457.09 Typical High $1,288.25 | Facility | None | $223.87 | $457.09 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $446.68 Typical High $1,819.70 | Professional | None | $245.47 | $446.68 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $549.54 | Professional | None | $331.13 | $398.11 | $549.54 |
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 $269.15 Median $549.54 Typical High $660.69 | Professional | None | $269.15 | $549.54 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $562.34 | Professional | None | $218.78 | $407.38 | $562.34 |
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 $190.55 Median $295.12 Typical High $562.34 | Professional | None | $190.55 | $295.12 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $660.69 | Professional | None | $426.58 | $501.19 | $660.69 |
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 $100.00 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $100.00 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $64.57 Typical High $77.62 | Professional | 53 · Discontinued | $40.74 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $151.36 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $30.20 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.42 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $269.15 |
Where Iowa sits
The same service costs 5.0 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· 6th of 51
$427
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.