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 $588.84 Median $2,630.27 Typical High $6,760.83 | Facility | None | $588.84 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $588.84 | Professional | None | $229.09 | $371.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $426.58 Typical High $549.54 | Facility | None | $316.23 | $426.58 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $616.60 Typical High $851.14 | Professional | None | $323.59 | $616.60 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $436.52 Typical High $549.54 | Professional | None | $204.17 | $436.52 | $549.54 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $724.44 Typical High $3,801.89 | Facility | None | $380.19 | $724.44 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $724.44 Typical High $2,630.27 | Professional | None | $371.54 | $724.44 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $891.25 | Professional | None | $524.81 | $630.96 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $288.40 Median $416.87 Typical High $549.54 | Facility | None | $288.40 | $416.87 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $977.24 | Professional | None | $562.34 | $616.60 | $977.24 |
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 $251.19 Median $407.38 Typical High $812.83 | Professional | None | $251.19 | $407.38 | $812.83 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $933.25 | Professional | None | $446.68 | $512.86 | $933.25 |
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 $186.21 Typical High $295.12 | Professional | 52 · Reduced service | $114.82 | $186.21 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $74.13 Typical High $117.49 | Professional | 53 · Discontinued | $45.71 | $74.13 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $281.84 Typical High $436.52 | Professional | 54 · Surgery only | $169.82 | $281.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $56.23 Typical High $87.10 | Professional | 55 · Aftercare only | $33.88 | $56.23 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $37.15 Typical High $58.88 | Professional | 56 · Pre-op care only | $22.91 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $263.03 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $158.49 | $263.03 | $407.38 |
Where Iowa sits
The same service costs 3.6 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
$562
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.