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 $616.60 Median $3,388.44 Typical High $6,760.83 | Facility | None | $616.60 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $676.08 | Professional | None | $363.08 | $616.60 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $707.95 | Facility | None | $380.19 | $512.86 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $831.76 Typical High $1,047.13 | Professional | None | $416.87 | $831.76 | $1,047.13 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $707.95 | Professional | None | $316.23 | $501.19 | $707.95 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $933.25 Typical High $2,884.03 | Facility | None | $457.09 | $933.25 | $2,884.03 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $2,884.03 | Professional | None | $501.19 | $831.76 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $977.24 | Professional | None | $776.25 | $851.14 | $977.24 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $512.86 Typical High $707.95 | Facility | None | $380.19 | $512.86 | $707.95 |
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 $501.19 Median $1,479.11 Typical High $4,073.80 | Facility | None | $501.19 | $1,479.11 | $4,073.80 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,096.48 | Professional | None | $389.05 | $588.84 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $954.99 | Professional | None | $630.96 | $758.58 | $954.99 |
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 $199.53 Median $309.03 Typical High $338.84 | Professional | 52 · Reduced service | $199.53 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $123.03 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $302.00 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $60.26 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $61.66 Typical High $67.61 | Professional | 56 · Pre-op care only | $39.81 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $281.84 | $436.52 | $478.63 |
Where Iowa sits
The same service costs 5.6 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
$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.