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 $208.93 Median $2,238.72 Typical High $6,606.93 | Facility | None | $208.93 | $2,238.72 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $371.54 | Professional | None | $102.33 | $194.98 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $239.88 | Facility | None | $151.36 | $199.53 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $426.58 | Professional | None | $229.09 | $323.59 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $208.93 Typical High $338.84 | Professional | None | $93.33 | $208.93 | $338.84 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $398.11 Typical High $1,621.81 | Facility | None | $199.53 | $398.11 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $794.33 | Professional | None | $190.55 | $316.23 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $407.38 | Professional | None | $229.09 | $302.00 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $147.91 Median $199.53 Typical High $239.88 | Facility | None | $147.91 | $199.53 | $239.88 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $446.68 | Professional | None | $117.49 | $223.87 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $316.23 | Professional | None | $186.21 | $208.93 | $316.23 |
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 $51.29 Median $97.72 Typical High $151.36 | Professional | 52 · Reduced service | $51.29 | $97.72 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $38.90 Typical High $60.26 | Professional | 53 · Discontinued | $20.42 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $147.91 Typical High $229.09 | Professional | 54 · Surgery only | $75.86 | $147.91 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $29.51 Typical High $45.71 | Professional | 55 · Aftercare only | $15.14 | $29.51 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $19.50 Typical High $30.20 | Professional | 56 · Pre-op care only | $10.23 | $19.50 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $138.04 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $70.79 | $138.04 | $213.80 |
Where Iowa sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$282
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.