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 $416.87 Median $2,630.27 Typical High $6,760.83 | Facility | None | $416.87 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $416.87 | Professional | None | $154.88 | $245.47 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,548.82 | Facility | None | $1,071.52 | $1,230.27 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $630.96 | Professional | None | $354.81 | $426.58 | $630.96 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $346.74 Typical High $512.86 | Professional | None | $147.91 | $346.74 | $512.86 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $724.44 Typical High $4,168.69 | Facility | None | $346.74 | $724.44 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,995.26 | Professional | None | $295.12 | $478.63 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $588.84 | Professional | None | $302.00 | $501.19 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,548.82 | Facility | None | $812.83 | $1,230.27 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $691.83 | Professional | None | $302.00 | $512.86 | $691.83 |
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 $177.83 Median $316.23 Typical High $616.60 | Professional | None | $177.83 | $316.23 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $660.69 | Professional | None | $302.00 | $354.81 | $660.69 |
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 $77.62 Median $123.03 Typical High $204.17 | Professional | 52 · Reduced service | $77.62 | $123.03 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $48.98 Typical High $83.18 | Professional | 53 · Discontinued | $30.90 | $48.98 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $186.21 Typical High $309.03 | Professional | 54 · Surgery only | $117.49 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $37.15 Typical High $61.66 | Professional | 55 · Aftercare only | $23.44 | $37.15 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $24.55 Typical High $41.69 | Professional | 56 · Pre-op care only | $15.49 | $24.55 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $173.78 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $109.65 | $173.78 | $288.40 |
Where Iowa sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$407
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.