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 $371.54 Median $2,630.27 Typical High $6,760.83 | Facility | None | $371.54 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $371.54 | Professional | None | $144.54 | $234.42 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $309.03 Typical High $389.05 | Facility | None | $251.19 | $309.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $575.44 | Professional | None | $223.87 | $407.38 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $128.82 Median $302.00 Typical High $501.19 | Professional | None | $128.82 | $302.00 | $501.19 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $616.60 Typical High $5,888.44 | Facility | None | $295.12 | $616.60 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $1,698.24 | Professional | None | $295.12 | $489.78 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $575.44 | Professional | None | $316.23 | $426.58 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $245.47 Median $295.12 Typical High $389.05 | Facility | None | $245.47 | $295.12 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $645.65 | Professional | None | $354.81 | $457.09 | $645.65 |
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 $165.96 Median $295.12 Typical High $549.54 | Professional | None | $165.96 | $295.12 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $575.44 | Professional | None | $281.84 | $331.13 | $575.44 |
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 $72.44 Median $117.49 Typical High $186.21 | Professional | 52 · Reduced service | $72.44 | $117.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $46.77 Typical High $74.13 | Professional | 53 · Discontinued | $28.84 | $46.77 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $177.83 Typical High $281.84 | Professional | 54 · Surgery only | $109.65 | $177.83 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $35.48 Typical High $56.23 | Professional | 55 · Aftercare only | $21.88 | $35.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.44 Typical High $37.15 | Professional | 56 · Pre-op care only | $14.45 | $23.44 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $165.96 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $102.33 | $165.96 | $263.03 |
Where Iowa sits
The same service costs 3.5 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
$372
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.