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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $776.25 | Professional | None | $316.23 | $501.19 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | None | $954.99 | $1,230.27 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,096.48 | Professional | None | $707.95 | $812.83 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $851.14 | Professional | None | $288.40 | $602.56 | $851.14 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,148.15 Typical High $4,677.35 | Facility | None | $630.96 | $1,148.15 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $3,388.44 | Professional | None | $562.34 | $912.01 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,096.48 | Professional | None | $602.56 | $870.96 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,445.44 | Facility | None | $912.01 | $1,230.27 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,174.90 | Professional | None | $616.60 | $933.25 | $1,174.90 |
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 $354.81 Median $602.56 Typical High $1,122.02 | Professional | None | $354.81 | $602.56 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,122.02 | Professional | None | $616.60 | $724.44 | $1,122.02 |
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 $158.49 Median $251.19 Typical High $363.08 | Professional | 52 · Reduced service | $158.49 | $251.19 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $100.00 Typical High $144.54 | Professional | 53 · Discontinued | $63.10 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $380.19 Typical High $537.03 | Professional | 54 · Surgery only | $239.88 | $380.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $75.86 Typical High $107.15 | Professional | 55 · Aftercare only | $47.86 | $75.86 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $50.12 Typical High $72.44 | Professional | 56 · Pre-op care only | $31.62 | $50.12 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $501.19 |
Where Iowa sits
The same service costs 4.9 times more in Alaska than in Utah. 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
$794
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.