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 $3,890.45 Median $7,244.36 Typical High $7,244.36 | Professional | None | $3,890.45 | $7,244.36 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $4,677.35 Median $10,000.00 Typical High $12,022.64 | Professional | None | $4,677.35 | $10,000.00 | $12,022.64 |
Hally Health Setting Professional Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $14,454.40 | Professional | None | $3,162.28 | $5,370.32 | $14,454.40 |
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 $3,090.30 Median $9,772.37 Typical High $31,622.78 | Professional | None | $3,090.30 | $9,772.37 | $31,622.78 |
Midlands Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $12,022.64 | Professional | None | $10,000.00 | $10,000.00 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $6,760.83 Median $9,772.37 Typical High $12,022.64 | Professional | None | $6,760.83 | $9,772.37 | $12,022.64 |
Oscar Health Setting Professional Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $10,471.29 | Professional | None | $4,466.84 | $8,317.64 | $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 $4,466.84 Median $6,309.57 Typical High $12,022.64 | Professional | None | $4,466.84 | $6,309.57 | $12,022.64 |
Wellmark Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $10,232.93 | Professional | None | $9,120.11 | $9,120.11 | $10,232.93 |
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 $1,949.84 Median $3,630.78 Typical High $3,630.78 | Professional | 52 · Reduced service | $1,949.84 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $776.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $5,370.32 Typical High $5,370.32 | Professional | 54 · Surgery only | $2,951.21 | $5,370.32 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $588.84 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $389.05 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $5,011.87 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $2,754.23 | $5,011.87 | $5,011.87 |
Where Iowa sits
The same service costs 21.9 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· 5th 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.