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 $3,388.44 Typical High $6,760.83 | Facility | None | $549.54 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $549.54 | Professional | None | $190.55 | $363.08 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $426.58 | Facility | None | $281.84 | $331.13 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $794.33 | Professional | None | $426.58 | $537.03 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $512.86 | Professional | None | $173.78 | $346.74 | $512.86 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $676.08 Typical High $4,677.35 | Facility | None | $371.54 | $676.08 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $501.19 Typical High $1,412.54 | Professional | None | $281.84 | $501.19 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $549.54 Typical High $776.25 | Professional | None | $426.58 | $549.54 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $426.58 | Facility | None | $269.15 | $309.03 | $426.58 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $218.78 Median $346.74 Typical High $691.83 | Professional | None | $218.78 | $346.74 | $691.83 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $588.84 | Professional | None | $346.74 | $389.05 | $588.84 |
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 $181.97 Typical High $275.42 | Professional | 52 · Reduced service | $95.50 | $181.97 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $72.44 Typical High $109.65 | Professional | 53 · Discontinued | $38.02 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $269.15 Typical High $407.38 | Professional | 54 · Surgery only | $141.25 | $269.15 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $53.70 Typical High $81.28 | Professional | 55 · Aftercare only | $28.18 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $36.31 Typical High $54.95 | Professional | 56 · Pre-op care only | $19.05 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $251.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $131.83 | $251.19 | $380.19 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$501
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.