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 $489.78 Median $2,630.27 Typical High $6,760.83 | Facility | None | $489.78 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $467.74 Typical High $489.78 | Professional | None | $275.42 | $467.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $234.42 Typical High $389.05 | Facility | None | $194.98 | $234.42 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $831.76 | Professional | None | $489.78 | $691.83 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $549.54 | Professional | None | $275.42 | $354.81 | $549.54 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $660.69 Typical High $1,621.81 | Facility | None | $239.88 | $660.69 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $691.83 Typical High $2,344.23 | Professional | None | $346.74 | $691.83 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $831.76 | Professional | None | $588.84 | $691.83 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $239.88 Typical High $416.87 | Facility | None | $173.78 | $239.88 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $870.96 | Professional | None | $537.03 | $776.25 | $870.96 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $794.33 | Professional | None | $288.40 | $436.52 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $831.76 | Professional | None | $602.56 | $707.95 | $831.76 |
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 $144.54 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $144.54 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $57.54 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $213.80 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $42.66 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $28.84 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $199.53 | $331.13 | $346.74 |
Where Iowa sits
The same service costs 5.5 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· 3rd of 51
$661
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.