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 $218.78 Median $691.83 Typical High $6,309.57 | Facility | None | $218.78 | $691.83 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $346.74 | Professional | None | $112.20 | $208.93 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $223.87 Typical High $309.03 | Facility | None | $91.20 | $223.87 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $512.86 | Professional | None | $245.47 | $331.13 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $407.38 | Professional | None | $100.00 | $223.87 | $407.38 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $398.11 Typical High $1,621.81 | Facility | None | $208.93 | $398.11 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $331.13 Typical High $977.24 | Professional | None | $181.97 | $331.13 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $512.86 | Professional | None | $245.47 | $354.81 | $512.86 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $208.93 Typical High $309.03 | Facility | None | $91.20 | $208.93 | $309.03 |
United Setting Facility Modifier None Typical Low $223.87 Median $1,096.48 Typical High $2,290.87 | Facility | None | $223.87 | $1,096.48 | $2,290.87 |
United Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $524.81 | Professional | None | $131.83 | $234.42 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $371.54 | Professional | None | $204.17 | $229.09 | $371.54 |
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 $54.95 Median $104.71 Typical High $173.78 | Professional | 52 · Reduced service | $54.95 | $104.71 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $41.69 Typical High $69.18 | Professional | 53 · Discontinued | $21.88 | $41.69 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $158.49 Typical High $263.03 | Professional | 54 · Surgery only | $83.18 | $158.49 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $16.60 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $20.89 Typical High $34.67 | Professional | 56 · Pre-op care only | $10.96 | $20.89 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $147.91 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $77.62 | $147.91 | $245.47 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$302
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.