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 $478.63 Median $3,388.44 Typical High $6,760.83 | Facility | None | $478.63 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $478.63 | Professional | None | $162.18 | $275.42 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $363.08 Typical High $478.63 | Facility | None | $309.03 | $363.08 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $707.95 | Professional | None | $239.88 | $457.09 | $707.95 |
Hally Health Setting Professional Modifier None Typical Low $141.25 Median $323.59 Typical High $489.78 | Professional | None | $141.25 | $323.59 | $489.78 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $645.65 Typical High $3,467.37 | Facility | None | $389.05 | $645.65 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $2,238.72 | Professional | None | $338.84 | $645.65 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $707.95 | Professional | None | $346.74 | $478.63 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $478.63 | Facility | None | $309.03 | $354.81 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Oscar Health Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $575.44 | Professional | None | $141.25 | $288.40 | $575.44 |
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 $181.97 Median $371.54 Typical High $741.31 | Professional | None | $181.97 | $371.54 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $676.08 | Professional | None | $281.84 | $331.13 | $676.08 |
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 $107.15 Median $138.04 Typical High $239.88 | Professional | 52 · Reduced service | $107.15 | $138.04 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $95.50 | Professional | 53 · Discontinued | $43.65 | $54.95 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $208.93 Typical High $354.81 | Professional | 54 · Surgery only | $162.18 | $208.93 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $41.69 Typical High $72.44 | Professional | 55 · Aftercare only | $32.36 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $27.54 Typical High $47.86 | Professional | 56 · Pre-op care only | $21.88 | $27.54 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $194.98 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $151.36 | $194.98 | $331.13 |
Where Iowa sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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
$479
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.