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 $204.17 Median $3,090.30 Typical High $6,760.83 | Facility | None | $204.17 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $204.17 | Professional | None | $114.82 | $147.91 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $204.17 | Facility | None | $102.33 | $154.88 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $467.74 | Professional | None | $269.15 | $323.59 | $467.74 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $223.87 Typical High $380.19 | Professional | None | $104.71 | $223.87 | $380.19 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $6,606.93 | Facility | None | $199.53 | $363.08 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $323.59 Typical High $831.76 | Professional | None | $199.53 | $323.59 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $467.74 | Professional | None | $269.15 | $316.23 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $95.50 Median $151.36 Typical High $204.17 | Facility | None | $95.50 | $151.36 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $302.00 Typical High $524.81 | Professional | None | $223.87 | $302.00 | $524.81 |
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 $131.83 Median $229.09 Typical High $389.05 | Professional | None | $131.83 | $229.09 | $389.05 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $389.05 | Professional | None | $204.17 | $239.88 | $389.05 |
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 $58.88 Median $69.18 Typical High $102.33 | Professional | 52 · Reduced service | $58.88 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $40.74 | Professional | 53 · Discontinued | $23.44 | $28.18 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $104.71 Typical High $151.36 | Professional | 54 · Surgery only | $87.10 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $20.89 Typical High $30.20 | Professional | 55 · Aftercare only | $17.38 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $20.42 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $97.72 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $81.28 | $97.72 | $141.25 |
Where Iowa sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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
$302
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.