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 $2,290.87 Typical High $6,760.83 | Facility | None | $223.87 | $2,290.87 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $346.74 | Professional | None | $109.65 | $190.55 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $218.78 Typical High $269.15 | Facility | None | $190.55 | $218.78 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $512.86 | Professional | None | $251.19 | $346.74 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $245.47 Typical High $426.58 | Professional | None | $100.00 | $245.47 | $426.58 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $346.74 Typical High $1,348.96 | Facility | None | $208.93 | $346.74 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $363.08 Typical High $831.76 | Professional | None | $213.80 | $363.08 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $512.86 | Professional | None | $251.19 | $416.87 | $512.86 |
Midlands Setting Facility Modifier None Typical Low $158.49 Median $229.09 Typical High $269.15 | Facility | None | $158.49 | $229.09 | $269.15 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $575.44 | Professional | None | $204.17 | $338.84 | $575.44 |
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 $120.23 Median $251.19 Typical High $478.63 | Professional | None | $120.23 | $251.19 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $446.68 | Professional | None | $204.17 | $239.88 | $446.68 |
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 $61.66 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $61.66 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $33.88 Typical High $54.95 | Professional | 53 · Discontinued | $24.55 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $128.82 Typical High $204.17 | Professional | 54 · Surgery only | $91.20 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $25.70 Typical High $40.74 | Professional | 55 · Aftercare only | $18.20 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $16.98 Typical High $26.92 | Professional | 56 · Pre-op care only | $12.30 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $120.23 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $85.11 | $120.23 | $190.55 |
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· 5th of 51
$295
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.