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 $512.86 Median $3,388.44 Typical High $6,760.83 | Facility | None | $512.86 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $549.54 | Professional | None | $229.09 | $380.19 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,778.28 | Facility | None | $954.99 | $1,148.15 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $724.44 | Professional | None | $309.03 | $562.34 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $416.87 Typical High $741.31 | Professional | None | $208.93 | $416.87 | $741.31 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $831.76 Typical High $4,466.84 | Facility | None | $489.78 | $831.76 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $2,290.87 | Professional | None | $389.05 | $660.69 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $758.58 | Professional | None | $512.86 | $630.96 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,778.28 | Facility | None | $954.99 | $1,174.90 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $630.96 Typical High $851.14 | Professional | None | $575.44 | $630.96 | $851.14 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $660.69 | Professional | None | $218.78 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $724.44 | Professional | None | $257.04 | $398.11 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $501.19 Typical High $758.58 | Professional | None | $446.68 | $501.19 | $758.58 |
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 $117.49 Median $190.55 Typical High $257.04 | Professional | 52 · Reduced service | $117.49 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $75.86 Typical High $102.33 | Professional | 53 · Discontinued | $46.77 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $288.40 Typical High $380.19 | Professional | 54 · Surgery only | $173.78 | $288.40 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $57.54 Typical High $75.86 | Professional | 55 · Aftercare only | $34.67 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $38.02 Typical High $51.29 | Professional | 56 · Pre-op care only | $23.44 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $269.15 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $162.18 | $269.15 | $354.81 |
Where Iowa sits
The same service costs 4.3 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· 6th of 51
$525
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.