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 $181.97 Median $2,511.89 Typical High $6,760.83 | Facility | None | $181.97 | $2,511.89 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $389.05 | Professional | None | $112.20 | $218.78 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,288.25 | Facility | None | $562.34 | $1,047.13 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $512.86 | Professional | None | $208.93 | $323.59 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $269.15 Typical High $549.54 | Professional | None | $97.72 | $269.15 | $549.54 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $645.65 Typical High $4,466.84 | Facility | None | $251.19 | $645.65 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $467.74 Typical High $1,621.81 | Professional | None | $239.88 | $467.74 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $407.38 Typical High $524.81 | Professional | None | $245.47 | $407.38 | $524.81 |
Midlands Setting Facility Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,288.25 | Facility | None | $588.84 | $1,023.29 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $602.56 | Professional | None | $288.40 | $398.11 | $602.56 |
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 $123.03 Median $234.42 Typical High $489.78 | Professional | None | $123.03 | $234.42 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $512.86 | Professional | None | $229.09 | $263.03 | $512.86 |
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 $56.23 Median $93.33 Typical High $173.78 | Professional | 52 · Reduced service | $56.23 | $93.33 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $37.15 Typical High $70.79 | Professional | 53 · Discontinued | $22.39 | $37.15 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $138.04 Typical High $263.03 | Professional | 54 · Surgery only | $83.18 | $138.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $27.54 Typical High $52.48 | Professional | 55 · Aftercare only | $16.98 | $27.54 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $11.22 | $18.62 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $128.82 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $77.62 | $128.82 | $245.47 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$309
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.