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 $346.74 Median $2,630.27 Typical High $6,760.83 | Facility | None | $346.74 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $407.38 | Professional | None | $190.55 | $316.23 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $281.84 | Facility | None | $114.82 | $218.78 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $549.54 | Professional | None | $416.87 | $478.63 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $436.52 | Professional | None | $177.83 | $309.03 | $436.52 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $489.78 Typical High $1,288.25 | Facility | None | $223.87 | $489.78 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $478.63 Typical High $1,621.81 | Professional | None | $257.04 | $478.63 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $446.68 Typical High $537.03 | Professional | None | $380.19 | $446.68 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $281.84 | Facility | None | $114.82 | $218.78 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $588.84 | Professional | None | $371.54 | $537.03 | $588.84 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $199.53 Median $302.00 Typical High $562.34 | Professional | None | $199.53 | $302.00 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $562.34 | Professional | None | $407.38 | $478.63 | $562.34 |
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 $97.72 Median $154.88 Typical High $173.78 | Professional | 52 · Reduced service | $97.72 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $63.10 Typical High $69.18 | Professional | 53 · Discontinued | $38.90 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $234.42 Typical High $257.04 | Professional | 54 · Surgery only | $147.91 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $46.77 Typical High $51.29 | Professional | 55 · Aftercare only | $29.51 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $31.62 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.50 | $31.62 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $218.78 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $138.04 | $218.78 | $239.88 |
Where Iowa sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 3rd of 51
$447
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.