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 $549.54 Median $3,235.94 Typical High $6,760.83 | Facility | None | $549.54 | $3,235.94 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $741.31 | Professional | None | $309.03 | $549.54 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $707.95 | Facility | None | $380.19 | $512.86 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $741.31 Typical High $912.01 | Professional | None | $363.08 | $741.31 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $602.56 | Professional | None | $275.42 | $398.11 | $602.56 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $831.76 Typical High $1,995.26 | Facility | None | $457.09 | $831.76 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $724.44 Typical High $2,511.89 | Professional | None | $407.38 | $724.44 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $851.14 | Professional | None | $691.83 | $741.31 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $707.95 | Facility | None | $380.19 | $512.86 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Oscar Health Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $691.83 | Professional | None | $288.40 | $537.03 | $691.83 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,445.44 Typical High $3,890.45 | Facility | None | $501.19 | $1,445.44 | $3,890.45 |
United Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $933.25 | Professional | None | $331.13 | $501.19 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $831.76 | Professional | None | $575.44 | $676.08 | $831.76 |
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 $169.82 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $169.82 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $67.61 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $239.88 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $51.29 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $33.88 | $54.95 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $380.19 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $239.88 | $380.19 | $407.38 |
Where Iowa sits
The same service costs 5.8 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
$646
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.