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 $457.09 Median $2,630.27 Typical High $6,760.83 | Facility | None | $457.09 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $457.09 | Professional | None | $223.87 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,071.52 Typical High $1,288.25 | Facility | None | $562.34 | $1,071.52 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $741.31 | Professional | None | $457.09 | $602.56 | $741.31 |
Hally Health Setting Professional Modifier None Typical Low $186.21 Median $380.19 Typical High $588.84 | Professional | None | $186.21 | $380.19 | $588.84 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $891.25 Typical High $4,466.84 | Facility | None | $457.09 | $891.25 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $1,513.56 | Professional | None | $363.08 | $602.56 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $741.31 | Professional | None | $457.09 | $616.60 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,288.25 | Facility | None | $616.60 | $1,071.52 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $831.76 | Professional | None | $457.09 | $602.56 | $831.76 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $245.47 Median $426.58 Typical High $758.58 | Professional | None | $245.47 | $426.58 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $676.08 | Professional | None | $416.87 | $467.74 | $676.08 |
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 $114.82 Median $169.82 Typical High $229.09 | Professional | 52 · Reduced service | $114.82 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $69.18 Typical High $91.20 | Professional | 53 · Discontinued | $45.71 | $69.18 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $257.04 Typical High $346.74 | Professional | 54 · Surgery only | $169.82 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $51.29 Typical High $69.18 | Professional | 55 · Aftercare only | $33.88 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $22.91 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $239.88 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $158.49 | $239.88 | $323.59 |
Where Iowa sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$575
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.