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 $302.00 Median $2,630.27 Typical High $6,760.83 | Facility | None | $302.00 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $446.68 | Professional | None | $173.78 | $229.09 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $3,388.44 | Facility | None | $645.65 | $2,691.53 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $691.83 | Professional | None | $371.54 | $501.19 | $691.83 |
Hally Health Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $537.03 | Professional | None | $169.82 | $323.59 | $537.03 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $870.96 Typical High $7,413.10 | Facility | None | $354.81 | $870.96 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $478.63 Typical High $3,162.28 | Professional | None | $281.84 | $478.63 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $691.83 | Professional | None | $371.54 | $501.19 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $3,388.44 | Facility | None | $1,445.44 | $2,630.27 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $776.25 | Professional | None | $331.13 | $489.78 | $776.25 |
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 $204.17 Median $338.84 Typical High $575.44 | Professional | None | $204.17 | $338.84 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $562.34 | Professional | None | $331.13 | $389.05 | $562.34 |
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 $89.13 Median $114.82 Typical High $151.36 | Professional | 52 · Reduced service | $89.13 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $45.71 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $173.78 Typical High $223.87 | Professional | 54 · Surgery only | $131.83 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $34.67 Typical High $45.71 | Professional | 55 · Aftercare only | $26.92 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $22.91 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.78 | $22.91 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $162.18 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $123.03 | $162.18 | $208.93 |
Where Iowa sits
The same service costs 4.4 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· 5th 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.