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 $537.03 Median $4,168.69 Typical High $7,244.36 | Facility | None | $537.03 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $346.74 Typical High $537.03 | Professional | None | $275.42 | $346.74 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $426.58 Typical High $575.44 | Facility | None | $354.81 | $426.58 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $588.84 Typical High $851.14 | Professional | None | $302.00 | $588.84 | $851.14 |
Hally Health Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $588.84 | Professional | None | $177.83 | $363.08 | $588.84 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $5,623.41 | Facility | None | $467.74 | $812.83 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $3,235.94 | Professional | None | $426.58 | $691.83 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $794.33 | Professional | None | $446.68 | $588.84 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $575.44 | Facility | None | $338.84 | $407.38 | $575.44 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $239.88 Median $446.68 Typical High $831.76 | Professional | None | $239.88 | $446.68 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $776.25 | Professional | None | $371.54 | $446.68 | $776.25 |
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 $138.04 Median $173.78 Typical High $269.15 | Professional | 52 · Reduced service | $138.04 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $69.18 Typical High $107.15 | Professional | 53 · Discontinued | $54.95 | $69.18 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $263.03 Typical High $398.11 | Professional | 54 · Surgery only | $204.17 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $34.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $27.54 | $34.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $245.47 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $190.55 | $245.47 | $371.54 |
Where Iowa sits
The same service costs 4.3 times more in Wyoming 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· 4th of 51
$575
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.