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 $1,905.46 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,905.46 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,511.89 | $3,090.30 | $3,715.35 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,995.26 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $2,089.30 Median $3,801.89 Typical High $12,882.50 | Facility | None | $2,089.30 | $3,801.89 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $9,772.37 | Professional | None | $1,445.44 | $2,884.03 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,570.40 | $2,951.21 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,398.83 | $3,162.28 | $4,466.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,630.27 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $7,244.36 Typical High $15,488.17 | Facility | None | $2,630.27 | $7,244.36 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,995.26 | $3,548.13 |
Wellmark Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,235.94 | Professional | None | $2,754.23 | $2,754.23 | $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 $602.56 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $602.56 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $245.47 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $912.01 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $181.97 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $120.23 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $851.14 | $1,318.26 | $1,318.26 |
Where Iowa sits
The same service costs 5.9 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· 8th of 51
$2,754
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.