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 $363.08 Median $4,677.35 Typical High $7,244.36 | Facility | None | $363.08 | $4,677.35 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $489.78 | Professional | None | $204.17 | $363.08 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,288.25 | $2,398.83 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $489.78 Typical High $588.84 | Professional | None | $239.88 | $489.78 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $707.95 | Professional | None | $194.98 | $323.59 | $707.95 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $1,862.09 Typical High $7,943.28 | Facility | None | $363.08 | $1,862.09 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $478.63 Typical High $1,584.89 | Professional | None | $245.47 | $478.63 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $489.78 Typical High $588.84 | Professional | None | $478.63 | $489.78 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $3,388.44 | Facility | None | $1,318.26 | $2,398.83 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $660.69 | Professional | None | $389.05 | $549.54 | $660.69 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $575.44 | Professional | None | $218.78 | $295.12 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | None | $436.52 | $436.52 | $478.63 |
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 $102.33 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $102.33 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $40.74 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $151.36 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $30.20 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $20.42 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $141.25 | $251.19 | $251.19 |
Where Iowa sits
The same service costs 5.6 times more in Alaska than in Utah. 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· 4th of 51
$479
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.