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 $309.03 Median $2,630.27 Typical High $6,760.83 | Facility | None | $309.03 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $309.03 | Professional | None | $114.82 | $194.98 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,454.71 | Facility | None | $645.65 | $2,089.30 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $302.00 Typical High $446.68 | Professional | None | $141.25 | $302.00 | $446.68 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $309.03 | Professional | None | $100.00 | $208.93 | $309.03 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $645.65 Typical High $5,888.44 | Facility | None | $257.04 | $645.65 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $1,318.26 | Professional | None | $218.78 | $363.08 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $446.68 | Professional | None | $245.47 | $302.00 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $676.08 Median $2,041.74 Typical High $2,454.71 | Facility | None | $676.08 | $2,041.74 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,309.57 | Facility | None | $724.44 | $3,090.30 | $6,309.57 |
United Setting Professional Modifier None Typical Low $125.89 Median $239.88 Typical High $457.09 | Professional | None | $125.89 | $239.88 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $436.52 | Professional | None | $204.17 | $239.88 | $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 $77.62 Median $97.72 Typical High $151.36 | Professional | 52 · Reduced service | $77.62 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $38.90 Typical High $61.66 | Professional | 53 · Discontinued | $30.90 | $38.90 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $114.82 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $29.51 Typical High $45.71 | Professional | 55 · Aftercare only | $22.91 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $138.04 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $107.15 | $138.04 | $213.80 |
Where Iowa sits
The same service costs 4.8 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· 4th of 51
$309
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.