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 $281.84 Median $436.52 Typical High $602.56 | Professional | None | $281.84 | $436.52 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $489.78 Typical High $616.60 | Facility | None | $407.38 | $489.78 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $912.01 | Professional | None | $616.60 | $741.31 | $912.01 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $776.25 | Professional | None | $245.47 | $501.19 | $776.25 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $954.99 Typical High $6,606.93 | Facility | None | $426.58 | $954.99 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $2,884.03 | Professional | None | $446.68 | $776.25 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $891.25 | Professional | None | $524.81 | $724.44 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $398.11 Median $467.74 Typical High $616.60 | Facility | None | $398.11 | $467.74 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,047.13 | Professional | None | $562.34 | $776.25 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $933.25 | Professional | None | $309.03 | $501.19 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $954.99 | Professional | None | $524.81 | $616.60 | $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 $141.25 Median $218.78 Typical High $302.00 | Professional | 52 · Reduced service | $141.25 | $218.78 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $87.10 Typical High $120.23 | Professional | 53 · Discontinued | $56.23 | $87.10 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $323.59 Typical High $446.68 | Professional | 54 · Surgery only | $208.93 | $323.59 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $64.57 Typical High $89.13 | Professional | 55 · Aftercare only | $41.69 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $43.65 Typical High $60.26 | Professional | 56 · Pre-op care only | $28.18 | $43.65 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $302.00 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $194.98 | $302.00 | $416.87 |
Where Iowa sits
The same service costs 4.8 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· 5th of 51
$676
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.