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 $275.42 Median $2,630.27 Typical High $6,760.83 | Facility | None | $275.42 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $275.42 | Professional | None | $169.82 | $245.47 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $154.88 Typical High $194.98 | Facility | None | $134.90 | $154.88 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $524.81 | Professional | None | $380.19 | $426.58 | $524.81 |
Hally Health Setting Professional Modifier None Typical Low $154.88 Median $288.40 Typical High $512.86 | Professional | None | $154.88 | $288.40 | $512.86 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $501.19 Typical High $5,248.07 | Facility | None | $190.55 | $501.19 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $1,230.27 | Professional | None | $269.15 | $446.68 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $524.81 | Professional | None | $380.19 | $426.58 | $524.81 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $194.98 | Facility | None | $123.03 | $154.88 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $588.84 | Professional | None | $316.23 | $446.68 | $588.84 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,388.44 Typical High $6,606.93 | Facility | None | $1,258.93 | $3,388.44 | $6,606.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $524.81 | Professional | None | $186.21 | $288.40 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $446.68 | Professional | None | $295.12 | $346.74 | $446.68 |
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 $85.11 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $85.11 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $33.88 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $128.82 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $25.70 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $16.98 | $24.55 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $120.23 | $169.82 | $194.98 |
Where Iowa sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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
$417
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.