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 $380.19 Median $2,630.27 Typical High $6,760.83 | Facility | None | $380.19 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $380.19 | Professional | None | $128.82 | $218.78 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $295.12 Typical High $398.11 | Facility | None | $257.04 | $295.12 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $549.54 | Professional | None | $208.93 | $363.08 | $549.54 |
Hally Health Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $467.74 | Professional | None | $120.23 | $275.42 | $467.74 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $588.84 Typical High $5,888.44 | Facility | None | $245.47 | $588.84 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $501.19 Typical High $1,698.24 | Professional | None | $257.04 | $501.19 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $562.34 | Professional | None | $295.12 | $436.52 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $398.11 | Facility | None | $239.88 | $295.12 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $645.65 | Professional | None | $331.13 | $416.87 | $645.65 |
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 $147.91 Median $257.04 Typical High $512.86 | Professional | None | $147.91 | $257.04 | $512.86 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $562.34 | Professional | None | $263.03 | $302.00 | $562.34 |
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 $66.07 Median $109.65 Typical High $186.21 | Professional | 52 · Reduced service | $66.07 | $109.65 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $43.65 Typical High $75.86 | Professional | 53 · Discontinued | $26.30 | $43.65 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $162.18 Typical High $281.84 | Professional | 54 · Surgery only | $100.00 | $162.18 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $32.36 Typical High $56.23 | Professional | 55 · Aftercare only | $19.95 | $32.36 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $151.36 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $93.33 | $151.36 | $263.03 |
Where Iowa sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$347
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.