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 $4,168.69 Median $5,248.07 Typical High $7,943.28 | Facility | None | $4,168.69 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $4,365.16 Median $7,943.28 Typical High $7,943.28 | Professional | None | $4,365.16 | $7,943.28 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $5,128.61 Median $10,964.78 Typical High $13,182.57 | Professional | None | $5,128.61 | $10,964.78 | $13,182.57 |
Hally Health Setting Professional Modifier None Typical Low $4,466.84 Median $7,079.46 Typical High $14,454.40 | Professional | None | $4,466.84 | $7,079.46 | $14,454.40 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $5,888.44 Typical High $13,182.57 | Facility | None | $588.84 | $5,888.44 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $5,623.41 Median $10,715.19 Typical High $35,481.34 | Professional | None | $5,623.41 | $10,715.19 | $35,481.34 |
Midlands Setting Professional Modifier None Typical Low $10,715.19 Median $10,964.78 Typical High $13,489.63 | Professional | None | $10,715.19 | $10,964.78 | $13,489.63 |
Midlands Setting Professional Modifier None Typical Low $8,511.38 Median $12,022.64 Typical High $15,135.61 | Professional | None | $8,511.38 | $12,022.64 | $15,135.61 |
Oscar Health Setting Professional Modifier None Typical Low $4,786.30 Median $8,912.51 Typical High $11,481.54 | Professional | None | $4,786.30 | $8,912.51 | $11,481.54 |
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 $5,128.61 Median $6,918.31 Typical High $13,182.57 | Professional | None | $5,128.61 | $6,918.31 | $13,182.57 |
Wellmark Setting Professional Modifier None Typical Low $10,000.00 Median $10,000.00 Typical High $10,964.78 | Professional | None | $10,000.00 | $10,000.00 | $10,964.78 |
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 $2,187.76 Median $3,981.07 Typical High $3,981.07 | Professional | 52 · Reduced service | $2,187.76 | $3,981.07 | $3,981.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,584.89 Typical High $1,584.89 | Professional | 53 · Discontinued | $870.96 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $5,888.44 Typical High $5,888.44 | Professional | 54 · Surgery only | $3,311.31 | $5,888.44 | $5,888.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $660.69 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $794.33 Typical High $794.33 | Professional | 56 · Pre-op care only | $436.52 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $5,495.41 Typical High $5,495.41 | Professional | 78 · Unplanned return to OR | $3,090.30 | $5,495.41 | $5,495.41 |
Where Iowa sits
The same service costs 20.0 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
$10,000
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.