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 $181.97 Median $5,011.87 Typical High $7,943.28 | Facility | None | $181.97 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $239.88 | Professional | None | $107.15 | $181.97 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $398.11 | Professional | None | $245.47 | $302.00 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $97.72 Median $186.21 Typical High $275.42 | Professional | None | $97.72 | $186.21 | $275.42 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $354.81 Typical High $1,288.25 | Facility | None | $169.82 | $354.81 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $794.33 | Professional | None | $177.83 | $288.40 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $398.11 | Professional | None | $245.47 | $302.00 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $104.71 Median $114.82 Typical High $131.83 | Facility | None | $104.71 | $114.82 | $131.83 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $436.52 | Professional | None | $204.17 | $281.84 | $436.52 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $354.81 | Professional | None | $120.23 | $204.17 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $346.74 | Professional | None | $194.98 | $229.09 | $346.74 |
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 $61.66 Median $89.13 Typical High $120.23 | Professional | 52 · Reduced service | $61.66 | $89.13 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $47.86 | Professional | 53 · Discontinued | $24.55 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $134.90 Typical High $181.97 | Professional | 54 · Surgery only | $91.20 | $134.90 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $26.92 Typical High $36.31 | Professional | 55 · Aftercare only | $18.62 | $26.92 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $125.89 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $85.11 | $125.89 | $169.82 |
Where Iowa sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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
$275
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.