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 $660.69 Median $3,548.13 Typical High $6,760.83 | Facility | None | $660.69 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | None | $389.05 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $794.33 Typical High $1,096.48 | Professional | None | $436.52 | $794.33 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $851.14 | Professional | None | $338.84 | $501.19 | $851.14 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $933.25 Typical High $3,890.45 | Facility | None | $524.81 | $933.25 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $812.83 Typical High $2,818.38 | Professional | None | $436.52 | $812.83 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,023.29 | Professional | None | $794.33 | $794.33 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $1,096.48 | Professional | None | $398.11 | $588.84 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | None | $676.08 | $676.08 | $794.33 |
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 $194.98 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $194.98 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $79.43 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $58.88 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $38.90 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $275.42 | $467.74 | $467.74 |
Where Iowa sits
The same service costs 6.9 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
$794
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.