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 $154.88 Median $5,011.87 Typical High $7,943.28 | Facility | None | $154.88 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $223.87 | Professional | None | $114.82 | $154.88 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $251.19 | Facility | None | $169.82 | $199.53 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $416.87 | Professional | None | $234.42 | $316.23 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $316.23 | Professional | None | $93.33 | $194.98 | $316.23 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $398.11 Typical High $3,801.89 | Facility | None | $158.49 | $398.11 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $776.25 | Professional | None | $190.55 | $316.23 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $416.87 | Professional | None | $234.42 | $338.84 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $251.19 | Facility | None | $158.49 | $199.53 | $251.19 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $467.74 | Professional | None | $194.98 | $295.12 | $467.74 |
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 $112.20 Median $218.78 Typical High $380.19 | Professional | None | $112.20 | $218.78 | $380.19 |
Wellmark Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $363.08 | Professional | None | $194.98 | $229.09 | $363.08 |
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 $57.54 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $57.54 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $30.90 Typical High $44.67 | Professional | 53 · Discontinued | $22.91 | $30.90 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $114.82 Typical High $165.96 | Professional | 54 · Surgery only | $85.11 | $114.82 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $22.91 Typical High $33.11 | Professional | 55 · Aftercare only | $16.98 | $22.91 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $15.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $11.48 | $15.49 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $107.15 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $79.43 | $107.15 | $154.88 |
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
$275
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.