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 $512.86 Median $5,248.07 Typical High $7,943.28 | Facility | None | $512.86 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $724.44 | Professional | None | $295.12 | $478.63 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $346.74 Typical High $407.38 | Facility | None | $269.15 | $346.74 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $870.96 | Professional | None | $416.87 | $660.69 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $1,318.26 | Professional | None | $245.47 | $389.05 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $870.96 Typical High $3,467.37 | Facility | None | $380.19 | $870.96 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $831.76 Typical High $4,466.84 | Professional | None | $446.68 | $831.76 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $794.33 | Professional | None | $616.60 | $660.69 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $251.19 Median $346.74 Typical High $426.58 | Facility | None | $251.19 | $346.74 | $426.58 |
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 $251.19 Median $467.74 Typical High $630.96 | Professional | None | $251.19 | $467.74 | $630.96 |
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 $316.23 Median $645.65 Typical High $1,348.96 | Professional | None | $316.23 | $645.65 | $1,348.96 |
Wellmark Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | None | $489.78 | $588.84 | $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 $151.36 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $151.36 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $95.50 Typical High $104.71 | Professional | 53 · Discontinued | $60.26 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $223.87 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $45.71 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.20 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $338.84 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $208.93 | $338.84 | $363.08 |
Where Iowa sits
The same service costs 5.0 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· 8th 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.