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 $457.09 Median $3,388.44 Typical High $6,760.83 | Facility | None | $457.09 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $457.09 | Professional | None | $190.55 | $245.47 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $870.96 Typical High $1,071.52 | Facility | None | $537.03 | $870.96 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $407.38 Typical High $676.08 | Professional | None | $208.93 | $407.38 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $457.09 | Professional | None | $123.03 | $309.03 | $457.09 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $741.31 Typical High $3,467.37 | Facility | None | $380.19 | $741.31 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $2,884.03 | Professional | None | $302.00 | $616.60 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $676.08 | Professional | None | $309.03 | $457.09 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,071.52 | Facility | None | $575.44 | $870.96 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Oscar Health Setting Professional Modifier None Typical Low $125.89 Median $269.15 Typical High $562.34 | Professional | None | $125.89 | $269.15 | $562.34 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,630.27 Typical High $5,495.41 | Facility | None | $724.44 | $2,630.27 | $5,495.41 |
United Setting Professional Modifier None Typical Low $158.49 Median $338.84 Typical High $707.95 | Professional | None | $158.49 | $338.84 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $660.69 | Professional | None | $251.19 | $295.12 | $660.69 |
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 $95.50 Median $120.23 Typical High $229.09 | Professional | 52 · Reduced service | $95.50 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $91.20 | Professional | 53 · Discontinued | $38.02 | $47.86 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $181.97 Typical High $346.74 | Professional | 54 · Surgery only | $141.25 | $181.97 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $69.18 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $45.71 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $169.82 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $131.83 | $169.82 | $323.59 |
Where Iowa sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 4th of 51
$457
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.