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 $4,265.80 Median $6,760.83 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,760.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,801.89 Median $7,079.46 Typical High $7,079.46 | Professional | None | $3,801.89 | $7,079.46 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,677.35 Median $9,772.37 Typical High $11,748.98 | Professional | None | $4,677.35 | $9,772.37 | $11,748.98 |
Hally Health Setting Professional Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $14,125.38 | Professional | None | $3,235.94 | $5,370.32 | $14,125.38 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $4,570.88 Typical High $11,748.98 | Facility | None | $588.84 | $4,570.88 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $3,162.28 Median $9,549.93 Typical High $31,622.78 | Professional | None | $3,162.28 | $9,549.93 | $31,622.78 |
Midlands Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $12,022.64 | Professional | None | $9,772.37 | $9,772.37 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $6,918.31 Median $9,549.93 Typical High $12,022.64 | Professional | None | $6,918.31 | $9,549.93 | $12,022.64 |
Oscar Health Setting Professional Modifier None Typical Low $4,466.84 Median $8,128.31 Typical High $10,471.29 | Professional | None | $4,466.84 | $8,128.31 | $10,471.29 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $6,309.57 Typical High $11,748.98 | Professional | None | $4,365.16 | $6,309.57 | $11,748.98 |
Wellmark Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,000.00 | Professional | None | $9,120.11 | $9,120.11 | $10,000.00 |
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 $1,905.46 Median $3,548.13 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,905.46 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $776.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,884.03 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $575.44 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $707.95 Typical High $707.95 | Professional | 56 · Pre-op care only | $389.05 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $2,691.53 | $4,897.79 | $4,897.79 |
Where Iowa sits
The same service costs 21.4 times more in Alaska than in Texas. 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
$9,120
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.