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 $144.54 Median $5,011.87 Typical High $7,943.28 | Facility | None | $144.54 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $144.54 Typical High $190.55 | Professional | None | $89.13 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $117.49 | Facility | None | $104.71 | $114.82 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $338.84 | Professional | None | $208.93 | $263.03 | $338.84 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $154.88 Typical High $213.80 | Professional | None | $85.11 | $154.88 | $213.80 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $309.03 Typical High $1,288.25 | Facility | None | $158.49 | $309.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $691.83 | Professional | None | $144.54 | $245.47 | $691.83 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $331.13 | Professional | None | $208.93 | $257.04 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $123.03 | Facility | None | $104.71 | $114.82 | $123.03 |
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 $107.15 Median $162.18 Typical High $316.23 | Professional | None | $107.15 | $162.18 | $316.23 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $169.82 Typical High $239.88 | Professional | None | $154.88 | $169.82 | $239.88 |
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 $44.67 Median $72.44 Typical High $95.50 | Professional | 52 · Reduced service | $44.67 | $72.44 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $28.84 Typical High $38.02 | Professional | 53 · Discontinued | $17.78 | $28.84 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $109.65 Typical High $141.25 | Professional | 54 · Surgery only | $66.07 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $21.88 Typical High $28.18 | Professional | 55 · Aftercare only | $13.18 | $21.88 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.45 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.91 | $14.45 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $102.33 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $61.66 | $102.33 | $131.83 |
Where Iowa sits
The same service costs 3.8 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· 4th of 51
$224
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.