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 $331.13 Median $549.54 Typical High $758.58 | Professional | None | $331.13 | $549.54 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,897.79 Typical High $5,888.44 | Facility | None | $954.99 | $4,897.79 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $912.01 Typical High $1,071.52 | Professional | None | $436.52 | $912.01 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $1,148.15 | Professional | None | $302.00 | $602.56 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $12,302.69 | Facility | None | $707.95 | $1,288.25 | $12,302.69 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $3,311.31 | Professional | None | $524.81 | $977.24 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,122.02 | Professional | None | $741.31 | $912.01 | $1,122.02 |
Midlands Setting Facility Modifier None Typical Low $1,778.28 Median $4,786.30 Typical High $5,888.44 | Facility | None | $1,778.28 | $4,786.30 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,258.93 | Professional | None | $831.76 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $15,488.17 | Facility | None | $1,258.93 | $3,630.78 | $15,488.17 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,096.48 | Professional | None | $389.05 | $588.84 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,148.15 | Professional | None | $676.08 | $776.25 | $1,148.15 |
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 $165.96 Median $275.42 Typical High $371.54 | Professional | 52 · Reduced service | $165.96 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $109.65 Typical High $151.36 | Professional | 53 · Discontinued | $66.07 | $109.65 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $416.87 Typical High $562.34 | Professional | 54 · Surgery only | $251.19 | $416.87 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $83.18 Typical High $112.20 | Professional | 55 · Aftercare only | $50.12 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $54.95 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.11 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $389.05 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $234.42 | $389.05 | $524.81 |
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· 5th of 51
$813
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.