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 $426.58 Median $2,630.27 Typical High $6,760.83 | Facility | None | $426.58 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $426.58 | Professional | None | $177.83 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $478.63 Typical High $645.65 | Facility | None | $234.42 | $478.63 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $436.52 Typical High $616.60 | Professional | None | $245.47 | $436.52 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $724.44 | Professional | None | $165.96 | $346.74 | $724.44 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $575.44 Typical High $1,621.81 | Facility | None | $316.23 | $575.44 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $562.34 Typical High $2,398.83 | Professional | None | $309.03 | $562.34 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $645.65 | Professional | None | $407.38 | $501.19 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $257.04 Median $478.63 Typical High $645.65 | Facility | None | $257.04 | $478.63 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $724.44 | Professional | None | $457.09 | $501.19 | $724.44 |
United Setting Facility Modifier None Typical Low $223.87 Median $1,000.00 Typical High $1,995.26 | Facility | None | $223.87 | $1,000.00 | $1,995.26 |
United Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $602.56 | Professional | None | $199.53 | $323.59 | $602.56 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $645.65 | Professional | None | $354.81 | $416.87 | $645.65 |
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 $91.20 Median $151.36 Typical High $213.80 | Professional | 52 · Reduced service | $91.20 | $151.36 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $60.26 Typical High $87.10 | Professional | 53 · Discontinued | $37.15 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $229.09 Typical High $323.59 | Professional | 54 · Surgery only | $138.04 | $229.09 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $45.71 Typical High $64.57 | Professional | 55 · Aftercare only | $27.54 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $30.20 Typical High $42.66 | Professional | 56 · Pre-op care only | $18.20 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $213.80 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $128.82 | $213.80 | $302.00 |
Where Iowa sits
The same service costs 4.2 times more in Alaska than in Texas. 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
$427
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.