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 $407.38 Median $2,630.27 Typical High $6,760.83 | Facility | None | $407.38 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $407.38 | Professional | None | $138.04 | $234.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $331.13 Typical High $416.87 | Facility | None | $199.53 | $331.13 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $575.44 | Professional | None | $239.88 | $398.11 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $125.89 Median $281.84 Typical High $489.78 | Professional | None | $125.89 | $281.84 | $489.78 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $1,288.25 | Facility | None | $275.42 | $446.68 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $1,778.28 | Professional | None | $275.42 | $537.03 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $602.56 | Professional | None | $316.23 | $467.74 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $323.59 Typical High $416.87 | Facility | None | $199.53 | $323.59 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $660.69 | Professional | None | $363.08 | $478.63 | $660.69 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $281.84 Typical High $562.34 | Professional | None | $141.25 | $281.84 | $562.34 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $154.88 Median $275.42 Typical High $562.34 | Professional | None | $154.88 | $275.42 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $660.69 | Professional | None | $295.12 | $338.84 | $660.69 |
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 $69.18 Median $117.49 Typical High $199.53 | Professional | 52 · Reduced service | $69.18 | $117.49 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $46.77 Typical High $81.28 | Professional | 53 · Discontinued | $28.18 | $46.77 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $173.78 Typical High $302.00 | Professional | 54 · Surgery only | $104.71 | $173.78 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $34.67 Typical High $60.26 | Professional | 55 · Aftercare only | $20.89 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $23.44 Typical High $40.74 | Professional | 56 · Pre-op care only | $13.80 | $23.44 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $162.18 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $97.72 | $162.18 | $281.84 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$363
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.