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 $295.12 Median $3,090.30 Typical High $6,760.83 | Facility | None | $295.12 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $338.84 | Professional | None | $144.54 | $234.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $263.03 Typical High $338.84 | Facility | None | $213.80 | $263.03 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $512.86 | Professional | None | $338.84 | $398.11 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $134.90 Median $295.12 Typical High $389.05 | Professional | None | $134.90 | $295.12 | $389.05 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $489.78 Typical High $3,981.07 | Facility | None | $263.03 | $489.78 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $478.63 Typical High $1,659.59 | Professional | None | $239.88 | $478.63 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $489.78 | Professional | None | $288.40 | $416.87 | $489.78 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $257.04 Typical High $338.84 | Facility | None | $199.53 | $257.04 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $562.34 | Professional | None | $281.84 | $398.11 | $562.34 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $489.78 | Professional | None | $162.18 | $263.03 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $562.34 | Professional | None | $295.12 | $346.74 | $562.34 |
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 $74.13 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $74.13 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $29.51 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $112.20 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $22.39 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $14.79 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $104.71 | $165.96 | $239.88 |
Where Iowa sits
The same service costs 3.5 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
$372
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.