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 $354.81 Median $2,630.27 Typical High $6,760.83 | Facility | None | $354.81 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $354.81 | Professional | None | $120.23 | $204.17 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $389.05 | Facility | None | $251.19 | $295.12 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $602.56 | Professional | None | $275.42 | $389.05 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $416.87 | Professional | None | $109.65 | $257.04 | $416.87 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $562.34 Typical High $5,888.44 | Facility | None | $239.88 | $562.34 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $416.87 Typical High $912.01 | Professional | None | $239.88 | $416.87 | $912.01 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $478.63 Typical High $602.56 | Professional | None | $275.42 | $478.63 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $239.88 Median $288.40 Typical High $389.05 | Facility | None | $239.88 | $288.40 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $676.08 | Professional | None | $251.19 | $380.19 | $676.08 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $8,709.64 | Facility | None | $724.44 | $3,090.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $524.81 | Professional | None | $141.25 | $295.12 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $524.81 | Professional | None | $251.19 | $281.84 | $524.81 |
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 $66.07 Median $102.33 Typical High $177.83 | Professional | 52 · Reduced service | $66.07 | $102.33 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $26.30 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $154.88 Typical High $269.15 | Professional | 54 · Surgery only | $100.00 | $154.88 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.90 Typical High $53.70 | Professional | 55 · Aftercare only | $19.95 | $30.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $20.42 Typical High $35.48 | Professional | 56 · Pre-op care only | $13.18 | $20.42 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $144.54 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $93.33 | $144.54 | $251.19 |
Where Iowa sits
The same service costs 3.8 times more in Wisconsin 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
$355
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.