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 $426.58 Median $2,238.72 Typical High $6,760.83 | Facility | None | $426.58 | $2,238.72 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $275.42 Typical High $426.58 | Professional | None | $181.97 | $275.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $478.63 | Facility | None | $309.03 | $389.05 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $489.78 Typical High $724.44 | Professional | None | $371.54 | $489.78 | $724.44 |
Hally Health Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $524.81 | Professional | None | $147.91 | $316.23 | $524.81 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $630.96 Typical High $5,888.44 | Facility | None | $295.12 | $630.96 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $524.81 Typical High $1,230.27 | Professional | None | $257.04 | $524.81 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $724.44 | Professional | None | $371.54 | $575.44 | $724.44 |
Midlands Setting Facility Modifier None Typical Low $309.03 Median $389.05 Typical High $478.63 | Facility | None | $309.03 | $389.05 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $831.76 | Professional | None | $338.84 | $524.81 | $831.76 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $8,709.64 | Facility | None | $724.44 | $3,090.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $190.55 Median $371.54 Typical High $660.69 | Professional | None | $190.55 | $371.54 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $616.60 | Professional | None | $338.84 | $380.19 | $616.60 |
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 $89.13 Median $138.04 Typical High $208.93 | Professional | 52 · Reduced service | $89.13 | $138.04 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $54.95 Typical High $85.11 | Professional | 53 · Discontinued | $35.48 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $208.93 Typical High $316.23 | Professional | 54 · Surgery only | $131.83 | $208.93 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $41.69 Typical High $63.10 | Professional | 55 · Aftercare only | $26.92 | $41.69 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $27.54 Typical High $42.66 | Professional | 56 · Pre-op care only | $17.78 | $27.54 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $194.98 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $123.03 | $194.98 | $295.12 |
Where Iowa sits
The same service costs 4.3 times more in Wisconsin 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· 6th of 51
$457
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.