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 $363.08 Median $3,162.28 Typical High $6,760.83 | Facility | None | $363.08 | $3,162.28 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $363.08 | Professional | None | $194.98 | $275.42 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $831.76 Typical High $954.99 | Facility | None | $524.81 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $602.56 | Professional | None | $436.52 | $489.78 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $354.81 Typical High $501.19 | Professional | None | $177.83 | $354.81 | $501.19 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $2,951.21 | Facility | None | $371.54 | $645.65 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $1,905.46 | Professional | None | $295.12 | $501.19 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $537.03 | Professional | None | $371.54 | $446.68 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $562.34 Median $831.76 Typical High $954.99 | Facility | None | $562.34 | $831.76 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $676.08 | Professional | None | $346.74 | $489.78 | $676.08 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,819.70 Typical High $4,073.80 | Facility | None | $501.19 | $1,819.70 | $4,073.80 |
United Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $602.56 | Professional | None | $208.93 | $323.59 | $602.56 |
Wellmark Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $645.65 | Professional | None | $363.08 | $436.52 | $645.65 |
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 $93.33 Median $138.04 Typical High $181.97 | Professional | 52 · Reduced service | $93.33 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $54.95 Typical High $72.44 | Professional | 53 · Discontinued | $37.15 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $204.17 Typical High $275.42 | Professional | 54 · Surgery only | $141.25 | $204.17 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $40.74 Typical High $54.95 | Professional | 55 · Aftercare only | $28.18 | $40.74 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $36.31 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $190.55 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $131.83 | $190.55 | $257.04 |
Where Iowa sits
The same service costs 4.3 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
$468
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.