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 $398.11 Median $2,630.27 Typical High $6,760.83 | Facility | None | $398.11 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $398.11 | Professional | None | $154.88 | $245.47 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $331.13 Typical High $426.58 | Facility | None | $281.84 | $331.13 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $602.56 | Professional | None | $354.81 | $416.87 | $602.56 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $331.13 Typical High $407.38 | Professional | None | $147.91 | $331.13 | $407.38 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $3,630.78 | Facility | None | $288.40 | $562.34 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $1,905.46 | Professional | None | $295.12 | $478.63 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $575.44 | Professional | None | $302.00 | $489.78 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $263.03 Median $323.59 Typical High $426.58 | Facility | None | $263.03 | $323.59 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $660.69 | Professional | None | $316.23 | $501.19 | $660.69 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $177.83 Median $316.23 Typical High $602.56 | Professional | None | $177.83 | $316.23 | $602.56 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $346.74 Typical High $645.65 | Professional | None | $295.12 | $346.74 | $645.65 |
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 $77.62 Median $123.03 Typical High $199.53 | Professional | 52 · Reduced service | $77.62 | $123.03 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $48.98 Typical High $79.43 | Professional | 53 · Discontinued | $30.90 | $48.98 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $181.97 Typical High $295.12 | Professional | 54 · Surgery only | $117.49 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $36.31 Typical High $58.88 | Professional | 55 · Aftercare only | $23.44 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $24.55 Typical High $39.81 | Professional | 56 · Pre-op care only | $15.49 | $24.55 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $169.82 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $109.65 | $169.82 | $275.42 |
Where Iowa sits
The same service costs 4.4 times more in Alaska than in Kentucky. 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
$398
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.