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 $169.82 Median $2,630.27 Typical High $6,760.83 | Facility | None | $169.82 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $177.83 | Professional | None | $144.54 | $169.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,288.25 | Facility | None | $562.34 | $1,047.13 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $512.86 | Professional | None | $346.74 | $407.38 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $398.11 | Professional | None | $144.54 | $251.19 | $398.11 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $645.65 Typical High $4,466.84 | Facility | None | $251.19 | $645.65 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $398.11 Typical High $1,174.90 | Professional | None | $229.09 | $398.11 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $512.86 | Professional | None | $354.81 | $389.05 | $512.86 |
Midlands Setting Facility Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,288.25 | Facility | None | $588.84 | $1,023.29 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $575.44 | Professional | None | $281.84 | $407.38 | $575.44 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $478.63 | Professional | None | $165.96 | $263.03 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $436.52 | Professional | None | $288.40 | $338.84 | $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 $72.44 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $72.44 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $32.36 Typical High $35.48 | Professional | 53 · Discontinued | $28.84 | $32.36 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $120.23 Typical High $131.83 | Professional | 54 · Surgery only | $107.15 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $24.55 Typical High $26.30 | Professional | 55 · Aftercare only | $21.38 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.22 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $16.22 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $112.20 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $100.00 | $112.20 | $123.03 |
Where Iowa sits
The same service costs 4.6 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
$380
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.