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 $275.42 Median $2,630.27 Typical High $6,760.83 | Facility | None | $275.42 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $177.83 Typical High $309.03 | Professional | None | $87.10 | $177.83 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $131.83 | Facility | None | $61.66 | $66.07 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $457.09 | Professional | None | $208.93 | $275.42 | $457.09 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $162.18 Typical High $269.15 | Professional | None | $85.11 | $162.18 | $269.15 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $1,380.38 | Facility | None | $125.89 | $407.38 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $257.04 Typical High $707.95 | Professional | None | $107.15 | $257.04 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $446.68 | Professional | None | $208.93 | $316.23 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $131.83 | Facility | None | $61.66 | $66.07 | $131.83 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $97.72 Median $190.55 Typical High $398.11 | Professional | None | $97.72 | $190.55 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $323.59 | Professional | None | $177.83 | $194.98 | $323.59 |
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 $46.77 Median $89.13 Typical High $154.88 | Professional | 52 · Reduced service | $46.77 | $89.13 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $36.31 Typical High $63.10 | Professional | 53 · Discontinued | $18.62 | $36.31 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $134.90 Typical High $234.42 | Professional | 54 · Surgery only | $69.18 | $134.90 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $26.92 Typical High $46.77 | Professional | 55 · Aftercare only | $13.80 | $26.92 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $17.78 Typical High $30.90 | Professional | 56 · Pre-op care only | $9.33 | $17.78 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $125.89 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $64.57 | $125.89 | $218.78 |
Where Iowa sits
The same service costs 4.5 times more in Alaska 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· 6th of 51
$245
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.