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 $416.87 Median $2,630.27 Typical High $6,760.83 | Facility | None | $416.87 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $416.87 Typical High $549.54 | Professional | None | $263.03 | $416.87 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Facility | None | $295.12 | $354.81 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $851.14 | Professional | None | $346.74 | $645.65 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $724.44 | Professional | None | $208.93 | $380.19 | $724.44 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $741.31 Typical High $2,187.76 | Facility | None | $389.05 | $741.31 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $2,818.38 | Professional | None | $426.58 | $645.65 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $758.58 | Professional | None | $524.81 | $660.69 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $281.84 Median $338.84 Typical High $436.52 | Facility | None | $281.84 | $338.84 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Oscar Health Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $616.60 | Professional | None | $213.80 | $398.11 | $616.60 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,479.11 Typical High $4,073.80 | Facility | None | $501.19 | $1,479.11 | $4,073.80 |
United Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $831.76 | Professional | None | $275.42 | $478.63 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $741.31 | Professional | None | $426.58 | $501.19 | $741.31 |
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 $141.25 Median $204.17 Typical High $257.04 | Professional | 52 · Reduced service | $141.25 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $102.33 | Professional | 53 · Discontinued | $56.23 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $389.05 | Professional | 54 · Surgery only | $208.93 | $309.03 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $61.66 Typical High $77.62 | Professional | 55 · Aftercare only | $42.66 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $51.29 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $363.08 |
Where Iowa sits
The same service costs 4.2 times more in Alaska than in Utah. 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
$562
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.