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 $208.93 Median $5,011.87 Typical High $7,943.28 | Facility | None | $208.93 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $346.74 | Professional | None | $128.82 | $208.93 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Facility | None | $61.66 | $61.66 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $630.96 | Professional | None | $302.00 | $407.38 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $416.87 | Professional | None | $123.03 | $281.84 | $416.87 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $426.58 Typical High $1,348.96 | Facility | None | $251.19 | $426.58 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $1,000.00 | Professional | None | $218.78 | $407.38 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $630.96 | Professional | None | $302.00 | $436.52 | $630.96 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $588.84 | Professional | None | $154.88 | $281.84 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $457.09 | Professional | None | $234.42 | $263.03 | $457.09 |
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 $64.57 Median $104.71 Typical High $173.78 | Professional | 52 · Reduced service | $64.57 | $104.71 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $41.69 Typical High $69.18 | Professional | 53 · Discontinued | $25.70 | $41.69 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $158.49 Typical High $263.03 | Professional | 54 · Surgery only | $97.72 | $158.49 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $19.50 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.89 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.88 | $20.89 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $147.91 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $91.20 | $147.91 | $245.47 |
Where Iowa sits
The same service costs 3.8 times more in Alaska than in Maryland. 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
$355
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.