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 $245.47 Median $2,630.27 Typical High $6,760.83 | Facility | None | $245.47 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $245.47 | Professional | None | $109.65 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $223.87 | Facility | None | $151.36 | $181.97 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $354.81 | Professional | None | $154.88 | $288.40 | $354.81 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $380.19 | Professional | None | $102.33 | $194.98 | $380.19 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $371.54 Typical High $3,890.45 | Facility | None | $190.55 | $371.54 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $316.23 Typical High $1,096.48 | Professional | None | $186.21 | $316.23 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $371.54 | Professional | None | $251.19 | $288.40 | $371.54 |
Midlands Setting Facility Modifier None Typical Low $144.54 Median $177.83 Typical High $223.87 | Facility | None | $144.54 | $177.83 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $398.11 | Professional | None | $281.84 | $295.12 | $398.11 |
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 $190.55 Typical High $346.74 | Professional | None | $123.03 | $190.55 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $371.54 | Professional | None | $223.87 | $251.19 | $371.54 |
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 $120.23 | Professional | 52 · Reduced service | $56.23 | $93.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $37.15 Typical High $48.98 | Professional | 53 · Discontinued | $22.39 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $83.18 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $28.18 Typical High $36.31 | Professional | 55 · Aftercare only | $16.60 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.62 Typical High $24.55 | Professional | 56 · Pre-op care only | $11.22 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $131.83 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $77.62 | $131.83 | $169.82 |
Where Iowa sits
The same service costs 4.0 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· 6th of 51
$251
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.