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 $407.38 Median $2,630.27 Typical High $6,760.83 | Facility | None | $407.38 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $407.38 | Professional | None | $165.96 | $257.04 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $323.59 Typical High $416.87 | Facility | None | $275.42 | $323.59 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $616.60 | Professional | None | $371.54 | $457.09 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $331.13 Typical High $436.52 | Professional | None | $151.36 | $331.13 | $436.52 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $645.65 Typical High $4,168.69 | Facility | None | $263.03 | $645.65 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $501.19 Typical High $1,905.46 | Professional | None | $295.12 | $501.19 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $588.84 | Professional | None | $316.23 | $489.78 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $416.87 | Facility | None | $269.15 | $323.59 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $676.08 | Professional | None | $323.59 | $501.19 | $676.08 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $616.60 | Professional | None | $181.97 | $316.23 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $645.65 | Professional | None | $309.03 | $363.08 | $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 $83.18 Median $128.82 Typical High $199.53 | Professional | 52 · Reduced service | $83.18 | $128.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $51.29 Typical High $81.28 | Professional | 53 · Discontinued | $33.11 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $194.98 Typical High $302.00 | Professional | 54 · Surgery only | $123.03 | $194.98 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $38.90 Typical High $60.26 | Professional | 55 · Aftercare only | $24.55 | $38.90 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $25.70 Typical High $40.74 | Professional | 56 · Pre-op care only | $16.60 | $25.70 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $181.97 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $114.82 | $181.97 | $281.84 |
Where Iowa sits
The same service costs 3.7 times more in Alaska than in Utah. 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
$437
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.