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 $245.47 Median $2,630.27 Typical High $6,760.83 | Facility | None | $245.47 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $269.15 | Professional | None | $128.82 | $204.17 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $645.65 | Facility | None | $204.17 | $269.15 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $371.54 | Professional | None | $288.40 | $323.59 | $371.54 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $316.23 | Professional | None | $123.03 | $213.80 | $316.23 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $380.19 Typical High $1,621.81 | Facility | None | $204.17 | $380.19 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $1,148.15 | Professional | None | $190.55 | $331.13 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $363.08 | Professional | None | $245.47 | $295.12 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $1,096.48 | Facility | None | $186.21 | $275.42 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $407.38 | Professional | None | $257.04 | $338.84 | $407.38 |
Oscar Health Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $331.13 | Professional | None | $128.82 | $239.88 | $331.13 |
United Setting Facility Modifier None Typical Low $223.87 Median $758.58 Typical High $1,995.26 | Facility | None | $223.87 | $758.58 | $1,995.26 |
United Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $407.38 | Professional | None | $141.25 | $218.78 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $380.19 | Professional | None | $251.19 | $295.12 | $380.19 |
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 $64.57 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $64.57 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $97.72 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $19.50 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $141.25 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $91.20 | $141.25 | $169.82 |
Where Iowa sits
The same service costs 3.8 times more in Alaska than in Delaware. 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
$295
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.