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 $75.86 Median $5,011.87 Typical High $7,943.28 | Facility | None | $75.86 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $81.28 | Professional | None | $46.77 | $75.86 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Facility | None | $36.31 | $36.31 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $144.54 | Professional | None | $97.72 | $117.49 | $144.54 |
Hally Health Setting Professional Modifier None Typical Low $44.67 Median $70.79 Typical High $93.33 | Professional | None | $44.67 | $70.79 | $93.33 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $134.90 Typical High $1,288.25 | Facility | None | $64.57 | $134.90 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $363.08 | Professional | None | $60.26 | $114.82 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $141.25 | Professional | None | $109.65 | $117.49 | $141.25 |
Midlands Setting Facility Modifier None Typical Low $36.31 Median $38.90 Typical High $42.66 | Facility | None | $36.31 | $38.90 | $42.66 |
United Setting Facility Modifier None Typical Low $112.20 Median $575.44 Typical High $1,995.26 | Facility | None | $112.20 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $141.25 | Professional | None | $53.70 | $75.86 | $141.25 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $104.71 | Professional | None | $83.18 | $93.33 | $104.71 |
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 $22.91 Median $38.02 Typical High $40.74 | Professional | 52 · Reduced service | $22.91 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $15.14 Typical High $16.22 | Professional | 53 · Discontinued | $9.12 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $57.54 Typical High $61.66 | Professional | 54 · Surgery only | $34.67 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $11.48 Typical High $12.30 | Professional | 55 · Aftercare only | $6.92 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.59 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.57 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $32.36 Median $53.70 Typical High $57.54 | Professional | 78 · Unplanned return to OR | $32.36 | $53.70 | $57.54 |
Where Iowa sits
The same service costs 4.6 times more in Alaska than in New York. 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· 3rd of 51
$107
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.