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 $309.03 Median $5,011.87 Typical High $7,943.28 | Facility | None | $309.03 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $309.03 Typical High $512.86 | Professional | None | $173.78 | $309.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $489.78 Typical High $616.60 | Facility | None | $288.40 | $489.78 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $741.31 | Professional | None | $281.84 | $436.52 | $741.31 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $457.09 | Professional | None | $165.96 | $302.00 | $457.09 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $616.60 Typical High $2,454.71 | Facility | None | $281.84 | $616.60 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $616.60 Typical High $2,290.87 | Professional | None | $269.15 | $616.60 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $776.25 | Professional | None | $371.54 | $549.54 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $616.60 | Facility | None | $288.40 | $478.63 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $891.25 | Professional | None | $363.08 | $512.86 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $204.17 Median $398.11 Typical High $724.44 | Professional | None | $204.17 | $398.11 | $724.44 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $4,073.80 | Facility | None | $501.19 | $1,819.70 | $4,073.80 |
United Setting Professional Modifier None Typical Low $177.83 Median $323.59 Typical High $691.83 | Professional | None | $177.83 | $323.59 | $691.83 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $870.96 | Professional | None | $426.58 | $501.19 | $870.96 |
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 $91.20 Median $154.88 Typical High $257.04 | Professional | 52 · Reduced service | $91.20 | $154.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $61.66 Typical High $102.33 | Professional | 53 · Discontinued | $36.31 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $229.09 Typical High $389.05 | Professional | 54 · Surgery only | $134.90 | $229.09 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $46.77 Typical High $77.62 | Professional | 55 · Aftercare only | $26.92 | $46.77 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $30.90 Typical High $51.29 | Professional | 56 · Pre-op care only | $18.20 | $30.90 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $213.80 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $125.89 | $213.80 | $363.08 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$479
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.