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 $2,290.87 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,290.87 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,258.93 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $3,162.28 Typical High $3,890.45 | Professional | None | $1,479.11 | $3,162.28 | $3,890.45 |
Hally Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $4,466.84 | Professional | None | $1,318.26 | $1,995.26 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,630.27 Typical High $4,897.79 | Facility | None | $588.84 | $2,630.27 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $3,090.30 Typical High $12,022.64 | Professional | None | $1,584.89 | $3,090.30 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,890.45 | Professional | None | $3,162.28 | $3,162.28 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,467.37 | $4,168.69 |
Oscar Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $3,311.31 | Professional | None | $1,412.54 | $2,630.27 | $3,311.31 |
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 $1,479.11 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,479.11 | $1,995.26 | $3,801.89 |
Wellmark Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,235.94 | Professional | None | $2,951.21 | $2,951.21 | $3,235.94 |
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 $630.96 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $630.96 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $251.19 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $954.99 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $190.55 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $125.89 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $891.25 | $1,621.81 | $1,621.81 |
Where Iowa sits
The same service costs 5.2 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· 6th of 51
$2,951
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.