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 $199.53 Median $2,630.27 Typical High $6,760.83 | Facility | None | $199.53 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $218.78 | Professional | None | $91.20 | $144.54 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $134.90 Typical High $173.78 | Facility | None | $93.33 | $134.90 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $295.12 | Professional | None | $204.17 | $251.19 | $295.12 |
Hally Health Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $263.03 | Professional | None | $85.11 | $169.82 | $263.03 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $288.40 Typical High $3,801.89 | Facility | None | $158.49 | $288.40 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $1,445.44 | Professional | None | $141.25 | $245.47 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $251.19 | Professional | None | $173.78 | $213.80 | $251.19 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $131.83 Typical High $173.78 | Facility | None | $91.20 | $131.83 | $173.78 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $338.84 | Professional | None | $165.96 | $245.47 | $338.84 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $281.84 | Professional | None | $95.50 | $154.88 | $281.84 |
Wellmark Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $316.23 | Professional | None | $173.78 | $204.17 | $316.23 |
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 $45.71 Median $72.44 Typical High $100.00 | Professional | 52 · Reduced service | $45.71 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.84 Typical High $39.81 | Professional | 53 · Discontinued | $18.20 | $28.84 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $107.15 Typical High $147.91 | Professional | 54 · Surgery only | $69.18 | $107.15 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $21.38 Typical High $29.51 | Professional | 55 · Aftercare only | $13.80 | $21.38 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.45 Typical High $19.95 | Professional | 56 · Pre-op care only | $9.12 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $100.00 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $64.57 | $100.00 | $138.04 |
Where Iowa sits
The same service costs 4.0 times more in Alaska than in Florida. 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
$214
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.