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 $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $645.65 | Professional | None | $323.59 | $416.87 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $426.58 Typical High $562.34 | Facility | None | $371.54 | $426.58 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $602.56 Typical High $933.25 | Professional | None | $331.13 | $602.56 | $933.25 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $436.52 Typical High $660.69 | Professional | None | $213.80 | $436.52 | $660.69 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $912.01 Typical High $5,623.41 | Facility | None | $489.78 | $912.01 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $851.14 Typical High $3,548.13 | Professional | None | $467.74 | $851.14 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $933.25 | Professional | None | $524.81 | $630.96 | $933.25 |
Midlands Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $562.34 | Facility | None | $354.81 | $416.87 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $275.42 Median $524.81 Typical High $977.24 | Professional | None | $275.42 | $524.81 | $977.24 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $912.01 | Professional | None | $407.38 | $478.63 | $912.01 |
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 $162.18 Median $208.93 Typical High $323.59 | Professional | 52 · Reduced service | $162.18 | $208.93 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $83.18 Typical High $128.82 | Professional | 53 · Discontinued | $64.57 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $239.88 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $95.50 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $41.69 Typical High $64.57 | Professional | 56 · Pre-op care only | $32.36 | $41.69 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $288.40 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $223.87 | $288.40 | $446.68 |
Where Iowa sits
The same service costs 3.9 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· 5th of 51
$646
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.