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 $478.63 Median $3,388.44 Typical High $6,760.83 | Facility | None | $478.63 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $478.63 | Professional | None | $218.78 | $338.84 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $363.08 Typical High $446.68 | Facility | None | $288.40 | $363.08 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $776.25 | Professional | None | $457.09 | $630.96 | $776.25 |
Hally Health Setting Professional Modifier None Typical Low $181.97 Median $398.11 Typical High $776.25 | Professional | None | $181.97 | $398.11 | $776.25 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $602.56 Typical High $1,513.56 | Facility | None | $302.00 | $602.56 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $1,479.11 | Professional | None | $354.81 | $630.96 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $776.25 | Professional | None | $457.09 | $645.65 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $275.42 Median $363.08 Typical High $478.63 | Facility | None | $275.42 | $363.08 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $891.25 | Professional | None | $436.52 | $602.56 | $891.25 |
United Setting Facility Modifier None Typical Low $223.87 Median $1,000.00 Typical High $1,995.26 | Facility | None | $223.87 | $1,000.00 | $1,995.26 |
United Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $851.14 | Professional | None | $239.88 | $457.09 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $707.95 | Professional | None | $407.38 | $446.68 | $707.95 |
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 $109.65 Median $169.82 Typical High $239.88 | Professional | 52 · Reduced service | $109.65 | $169.82 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $67.61 Typical High $95.50 | Professional | 53 · Discontinued | $43.65 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $363.08 | Professional | 54 · Surgery only | $162.18 | $257.04 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $51.29 Typical High $72.44 | Professional | 55 · Aftercare only | $32.36 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $33.88 Typical High $47.86 | Professional | 56 · Pre-op care only | $21.88 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $239.88 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $151.36 | $239.88 | $338.84 |
Where Iowa sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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· 6th of 51
$537
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.