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 $398.11 Median $2,630.27 Typical High $6,760.83 | Facility | None | $398.11 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $398.11 | Professional | None | $165.96 | $251.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $426.58 | Facility | None | $281.84 | $331.13 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $602.56 | Professional | None | $354.81 | $446.68 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $426.58 | Professional | None | $147.91 | $323.59 | $426.58 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $562.34 Typical High $3,630.78 | Facility | None | $269.15 | $562.34 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,905.46 | Professional | None | $295.12 | $478.63 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $588.84 | Professional | None | $302.00 | $489.78 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $426.58 | Facility | None | $269.15 | $323.59 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $660.69 | Professional | None | $316.23 | $501.19 | $660.69 |
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 $181.97 Median $316.23 Typical High $616.60 | Professional | None | $181.97 | $316.23 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $645.65 | Professional | None | $302.00 | $354.81 | $645.65 |
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 $79.43 Median $125.89 Typical High $199.53 | Professional | 52 · Reduced service | $79.43 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $50.12 Typical High $79.43 | Professional | 53 · Discontinued | $31.62 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $295.12 | Professional | 54 · Surgery only | $120.23 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $60.26 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.12 Typical High $39.81 | Professional | 56 · Pre-op care only | $15.85 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $173.78 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $112.20 | $173.78 | $275.42 |
Where Iowa sits
The same service costs 3.5 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
$398
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.