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 $234.42 Median $2,630.27 Typical High $6,760.83 | Facility | None | $234.42 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $323.59 | Professional | None | $123.03 | $169.82 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $218.78 Typical High $281.84 | Facility | None | $123.03 | $218.78 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $537.03 | Professional | None | $263.03 | $371.54 | $537.03 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $331.13 | Professional | None | $120.23 | $218.78 | $331.13 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $446.68 Typical High $4,897.79 | Facility | None | $213.80 | $446.68 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $354.81 Typical High $1,000.00 | Professional | None | $204.17 | $354.81 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $537.03 | Professional | None | $263.03 | $371.54 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $208.93 Typical High $281.84 | Facility | None | $123.03 | $208.93 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $602.56 | Professional | None | $223.87 | $346.74 | $602.56 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $398.11 | Professional | None | $141.25 | $234.42 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $436.52 | Professional | None | $239.88 | $281.84 | $436.52 |
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 $63.10 Median $83.18 Typical High $117.49 | Professional | 52 · Reduced service | $63.10 | $83.18 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.11 Typical High $46.77 | Professional | 53 · Discontinued | $25.70 | $33.11 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $123.03 Typical High $177.83 | Professional | 54 · Surgery only | $95.50 | $123.03 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $25.12 Typical High $35.48 | Professional | 55 · Aftercare only | $19.05 | $25.12 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.60 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.59 | $16.60 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $114.82 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $89.13 | $114.82 | $165.96 |
Where Iowa sits
The same service costs 3.9 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
$324
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.