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 $588.84 Median $2,630.27 Typical High $6,760.83 | Facility | None | $588.84 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $588.84 | Professional | None | $257.04 | $416.87 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $467.74 Typical High $588.84 | Facility | None | $380.19 | $467.74 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $891.25 | Professional | None | $575.44 | $660.69 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $389.05 Typical High $912.01 | Professional | None | $239.88 | $389.05 | $912.01 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $724.44 Typical High $3,630.78 | Facility | None | $371.54 | $724.44 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $794.33 Typical High $2,754.23 | Professional | None | $407.38 | $794.33 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $831.76 | Professional | None | $512.86 | $707.95 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $354.81 Median $467.74 Typical High $588.84 | Facility | None | $354.81 | $467.74 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,023.29 | Professional | None | $501.19 | $724.44 | $1,023.29 |
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 $281.84 Median $446.68 Typical High $851.14 | Professional | None | $281.84 | $446.68 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $977.24 | Professional | None | $524.81 | $616.60 | $977.24 |
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 $131.83 Median $208.93 Typical High $295.12 | Professional | 52 · Reduced service | $131.83 | $208.93 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $83.18 Typical High $117.49 | Professional | 53 · Discontinued | $53.70 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $309.03 Typical High $436.52 | Professional | 54 · Surgery only | $199.53 | $309.03 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $61.66 Typical High $87.10 | Professional | 55 · Aftercare only | $39.81 | $61.66 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $41.69 Typical High $58.88 | Professional | 56 · Pre-op care only | $26.92 | $41.69 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $288.40 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $186.21 | $288.40 | $407.38 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$617
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.