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 $3,981.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,981.07 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,187.76 | $3,981.07 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $5,495.41 Typical High $6,760.83 | Professional | None | $2,570.40 | $5,495.41 | $6,760.83 |
Hally Health Setting Professional Modifier None Typical Low $2,290.87 Median $3,311.31 Typical High $7,413.10 | Professional | None | $2,290.87 | $3,311.31 | $7,413.10 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $3,467.37 Typical High $6,918.31 | Facility | None | $588.84 | $3,467.37 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $2,754.23 Median $5,370.32 Typical High $17,782.79 | Professional | None | $2,754.23 | $5,370.32 | $17,782.79 |
Midlands Setting Professional Modifier None Typical Low $5,370.32 Median $5,495.41 Typical High $6,760.83 | Professional | None | $5,370.32 | $5,495.41 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $4,365.16 Median $6,025.60 Typical High $7,079.46 | Professional | None | $4,365.16 | $6,025.60 | $7,079.46 |
Oscar Health Setting Professional Modifier None Typical Low $2,454.71 Median $4,466.84 Typical High $5,754.40 | Professional | None | $2,454.71 | $4,466.84 | $5,754.40 |
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 $2,570.40 Median $3,467.37 Typical High $6,606.93 | Professional | None | $2,570.40 | $3,467.37 | $6,606.93 |
Wellmark Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,623.41 | Professional | None | $5,011.87 | $5,011.87 | $5,623.41 |
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 $1,096.48 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,096.48 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $436.52 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,659.59 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $331.13 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $218.78 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,818.38 | $2,818.38 |
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
$5,012
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.