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 $602.56 Median $2,630.27 Typical High $6,760.83 | Facility | None | $602.56 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $602.56 Typical High $758.58 | Professional | None | $371.54 | $602.56 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $630.96 | Facility | None | $398.11 | $489.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $812.83 Typical High $1,122.02 | Professional | None | $407.38 | $812.83 | $1,122.02 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $724.44 | Professional | None | $309.03 | $524.81 | $724.44 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,071.52 Typical High $5,623.41 | Facility | None | $478.63 | $1,071.52 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $3,235.94 | Professional | None | $524.81 | $933.25 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,096.48 | Professional | None | $758.58 | $912.01 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $630.96 | Facility | None | $371.54 | $478.63 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,548.13 Typical High $7,413.10 | Facility | None | $1,258.93 | $3,548.13 | $7,413.10 |
United Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,071.52 | Professional | None | $371.54 | $616.60 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,096.48 | Professional | None | $630.96 | $741.31 | $1,096.48 |
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 $204.17 Median $302.00 Typical High $380.19 | Professional | 52 · Reduced service | $204.17 | $302.00 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $120.23 Typical High $151.36 | Professional | 53 · Discontinued | $81.28 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $446.68 Typical High $575.44 | Professional | 54 · Surgery only | $302.00 | $446.68 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $91.20 Typical High $114.82 | Professional | 55 · Aftercare only | $60.26 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $60.26 Typical High $75.86 | Professional | 56 · Pre-op care only | $40.74 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $416.87 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $281.84 | $416.87 | $537.03 |
Where Iowa sits
The same service costs 5.0 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
$776
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.