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 $302.00 Median $446.68 Typical High $741.31 | Professional | None | $302.00 | $446.68 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $281.84 Typical High $363.08 | Facility | None | $218.78 | $281.84 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $691.83 Typical High $1,096.48 | Professional | None | $338.84 | $691.83 | $1,096.48 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $512.86 Typical High $776.25 | Professional | None | $229.09 | $512.86 | $776.25 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $707.95 Typical High $1,513.56 | Facility | None | $251.19 | $707.95 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $4,168.69 | Professional | None | $549.54 | $1,000.00 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,096.48 | Professional | None | $562.34 | $741.31 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $363.08 | Facility | None | $204.17 | $281.84 | $363.08 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $223.87 Median $851.14 Typical High $1,995.26 | Facility | None | $223.87 | $851.14 | $1,995.26 |
United Setting Professional Modifier None Typical Low $295.12 Median $602.56 Typical High $1,148.15 | Professional | None | $295.12 | $602.56 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $1,071.52 | Professional | None | $446.68 | $524.81 | $1,071.52 |
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 $173.78 Median $223.87 Typical High $371.54 | Professional | 52 · Reduced service | $173.78 | $223.87 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $89.13 Typical High $147.91 | Professional | 53 · Discontinued | $69.18 | $89.13 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $338.84 Typical High $562.34 | Professional | 54 · Surgery only | $263.03 | $338.84 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $112.20 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $74.13 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $316.23 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $245.47 | $316.23 | $524.81 |
Where Iowa sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$708
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.