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 $223.87 Median $5,011.87 Typical High $7,943.28 | Facility | None | $223.87 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $295.12 Typical High $660.69 | Professional | None | $138.04 | $295.12 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $181.97 Typical High $229.09 | Facility | None | $107.15 | $181.97 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $794.33 | Professional | None | $281.84 | $457.09 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $426.58 Typical High $512.86 | Professional | None | $128.82 | $426.58 | $512.86 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $489.78 Typical High $1,348.96 | Facility | None | $186.21 | $489.78 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $524.81 Typical High $2,570.40 | Professional | None | $275.42 | $524.81 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $602.56 Typical High $707.95 | Professional | None | $239.88 | $602.56 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $107.15 Median $181.97 Typical High $229.09 | Facility | None | $107.15 | $181.97 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $512.86 Typical High $954.99 | Professional | None | $263.03 | $512.86 | $954.99 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $151.36 Median $323.59 Typical High $707.95 | Professional | None | $151.36 | $323.59 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $912.01 | Professional | None | $302.00 | $354.81 | $912.01 |
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 $70.79 Median $128.82 Typical High $257.04 | Professional | 52 · Reduced service | $70.79 | $128.82 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $51.29 Typical High $104.71 | Professional | 53 · Discontinued | $28.18 | $51.29 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $190.55 Typical High $389.05 | Professional | 54 · Surgery only | $107.15 | $190.55 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $38.02 Typical High $77.62 | Professional | 55 · Aftercare only | $21.38 | $38.02 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $25.70 Typical High $52.48 | Professional | 56 · Pre-op care only | $14.13 | $25.70 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $177.83 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $100.00 | $177.83 | $363.08 |
Where Iowa sits
The same service costs 3.6 times more in Wisconsin 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· 4th of 51
$437
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.