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 $512.86 Median $5,011.87 Typical High $7,943.28 | Facility | None | $512.86 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $776.25 | Professional | None | $295.12 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $660.69 Typical High $831.76 | Facility | None | $436.52 | $660.69 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $724.44 Typical High $1,122.02 | Professional | None | $426.58 | $724.44 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $1,071.52 | Professional | None | $275.42 | $467.74 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $1,047.13 Typical High $8,128.31 | Facility | None | $512.86 | $1,047.13 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $912.01 Typical High $3,467.37 | Professional | None | $363.08 | $912.01 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,174.90 | Professional | None | $602.56 | $831.76 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $426.58 Median $645.65 Typical High $831.76 | Facility | None | $426.58 | $645.65 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,318.26 | Professional | None | $741.31 | $831.76 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,011.87 | $10,715.19 |
United Setting Professional Modifier None Typical Low $323.59 Median $512.86 Typical High $1,047.13 | Professional | None | $323.59 | $512.86 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,258.93 | Professional | None | $660.69 | $758.58 | $1,258.93 |
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 $154.88 Median $257.04 Typical High $389.05 | Professional | 52 · Reduced service | $154.88 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $61.66 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $389.05 Typical High $588.84 | Professional | 54 · Surgery only | $234.42 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $77.62 Typical High $117.49 | Professional | 55 · Aftercare only | $46.77 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $30.90 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $363.08 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $218.78 | $363.08 | $549.54 |
Where Iowa sits
The same service costs 4.3 times more in Alaska 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· 6th of 51
$741
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.