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 $177.83 Median $5,011.87 Typical High $7,943.28 | Facility | None | $177.83 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $316.23 | Professional | None | $128.82 | $218.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $48.98 | Facility | None | $45.71 | $45.71 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $588.84 | Professional | None | $257.04 | $389.05 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $107.15 Median $281.84 Typical High $407.38 | Professional | None | $107.15 | $281.84 | $407.38 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $380.19 Typical High $1,288.25 | Facility | None | $181.97 | $380.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $954.99 | Professional | None | $239.88 | $416.87 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $416.87 Typical High $588.84 | Professional | None | $257.04 | $416.87 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $48.98 Typical High $53.70 | Facility | None | $45.71 | $48.98 | $53.70 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $389.05 Typical High $660.69 | Professional | None | $245.47 | $389.05 | $660.69 |
United Setting Facility Modifier None Typical Low $173.78 Median $575.44 Typical High $1,995.26 | Facility | None | $173.78 | $575.44 | $1,995.26 |
United Setting Professional Modifier None Typical Low $128.82 Median $269.15 Typical High $549.54 | Professional | None | $128.82 | $269.15 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $501.19 | Professional | None | $229.09 | $269.15 | $501.19 |
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 $67.61 Median $95.50 Typical High $151.36 | Professional | 52 · Reduced service | $67.61 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.90 Typical High $60.26 | Professional | 53 · Discontinued | $26.92 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $144.54 Typical High $229.09 | Professional | 54 · Surgery only | $100.00 | $144.54 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $45.71 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.05 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.49 | $19.05 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $134.90 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $93.33 | $134.90 | $213.80 |
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· 4th of 51
$339
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.