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 $295.12 Median $2,630.27 Typical High $6,760.83 | Facility | None | $295.12 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $186.21 Typical High $295.12 | Professional | None | $109.65 | $186.21 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $223.87 Typical High $281.84 | Facility | None | $173.78 | $223.87 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $426.58 | Professional | None | $162.18 | $302.00 | $426.58 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $288.40 | Professional | None | $100.00 | $223.87 | $288.40 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $380.19 Typical High $1,348.96 | Facility | None | $190.55 | $380.19 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $380.19 Typical High $1,318.26 | Professional | None | $181.97 | $380.19 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $446.68 | Professional | None | $245.47 | $338.84 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $208.93 Typical High $281.84 | Facility | None | $173.78 | $208.93 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $489.78 | Professional | None | $275.42 | $323.59 | $489.78 |
United Setting Facility Modifier None Typical Low $223.87 Median $1,000.00 Typical High $1,995.26 | Facility | None | $223.87 | $1,000.00 | $1,995.26 |
United Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $426.58 | Professional | None | $123.03 | $208.93 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $457.09 | Professional | None | $218.78 | $251.19 | $457.09 |
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 $54.95 Median $91.20 Typical High $147.91 | Professional | 52 · Reduced service | $54.95 | $91.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $37.15 Typical High $58.88 | Professional | 53 · Discontinued | $21.88 | $37.15 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $138.04 Typical High $218.78 | Professional | 54 · Surgery only | $83.18 | $138.04 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $27.54 Typical High $43.65 | Professional | 55 · Aftercare only | $16.60 | $27.54 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.62 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.96 | $18.62 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $128.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $77.62 | $128.82 | $204.17 |
Where Iowa sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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.