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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $602.56 | Professional | None | $269.15 | $446.68 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $2,884.03 | Facility | None | $954.99 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $707.95 Typical High $870.96 | Professional | None | $354.81 | $707.95 | $870.96 |
Hally Health Setting Professional Modifier None Typical Low $239.88 Median $478.63 Typical High $831.76 | Professional | None | $239.88 | $478.63 | $831.76 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,023.29 Typical High $7,244.36 | Facility | None | $562.34 | $1,023.29 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $794.33 Typical High $2,691.53 | Professional | None | $398.11 | $794.33 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | None | $602.56 | $724.44 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $2,884.03 | Facility | None | $1,148.15 | $2,238.72 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,000.00 | Professional | None | $676.08 | $724.44 | $1,000.00 |
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 $309.03 Median $467.74 Typical High $870.96 | Professional | None | $309.03 | $467.74 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $912.01 | Professional | None | $537.03 | $602.56 | $912.01 |
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 $134.90 Median $223.87 Typical High $302.00 | Professional | 52 · Reduced service | $134.90 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $89.13 Typical High $120.23 | Professional | 53 · Discontinued | $53.70 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $331.13 Typical High $457.09 | Professional | 54 · Surgery only | $199.53 | $331.13 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $67.61 Typical High $91.20 | Professional | 55 · Aftercare only | $39.81 | $67.61 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $44.67 Typical High $60.26 | Professional | 56 · Pre-op care only | $26.92 | $44.67 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $309.03 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $186.21 | $309.03 | $426.58 |
Where Iowa sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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
$646
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.