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 $269.15 Median $416.87 Typical High $588.84 | Professional | None | $269.15 | $416.87 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $616.60 | Facility | None | $389.05 | $501.19 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $912.01 | Professional | None | $602.56 | $758.58 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $501.19 Typical High $776.25 | Professional | None | $239.88 | $501.19 | $776.25 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $912.01 Typical High $6,606.93 | Facility | None | $426.58 | $912.01 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $2,754.23 | Professional | None | $446.68 | $776.25 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $912.01 | Professional | None | $512.86 | $724.44 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $371.54 Median $467.74 Typical High $616.60 | Facility | None | $371.54 | $467.74 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $1,023.29 | Professional | None | $549.54 | $794.33 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $933.25 | Professional | None | $302.00 | $501.19 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $933.25 | Professional | None | $512.86 | $602.56 | $933.25 |
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 $134.90 Median $208.93 Typical High $295.12 | Professional | 52 · Reduced service | $134.90 | $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 $316.23 Typical High $446.68 | Professional | 54 · Surgery only | $199.53 | $316.23 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $63.10 Typical High $89.13 | Professional | 55 · Aftercare only | $40.74 | $63.10 | $89.13 |
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 $295.12 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $186.21 | $295.12 | $416.87 |
Where Iowa sits
The same service costs 5.2 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
$661
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.