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 $602.56 Median $2,951.21 Typical High $6,760.83 | Facility | None | $602.56 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $457.09 Typical High $457.09 | Professional | None | $245.47 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $3,019.95 | Facility | None | $1,174.90 | $2,344.23 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $549.54 Typical High $758.58 | Professional | None | $302.00 | $549.54 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $1,096.48 | Professional | None | $251.19 | $331.13 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $1,096.48 Typical High $6,309.57 | Facility | None | $323.59 | $1,096.48 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $1,995.26 | Professional | None | $288.40 | $537.03 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $758.58 | Professional | None | $549.54 | $549.54 | $758.58 |
Midlands Setting Facility Modifier None Typical Low $1,174.90 Median $2,290.87 Typical High $3,019.95 | Facility | None | $1,174.90 | $2,290.87 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $758.58 | Professional | None | $426.58 | $691.83 | $758.58 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $7,413.10 | Facility | None | $724.44 | $3,090.30 | $7,413.10 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $676.08 | Professional | None | $251.19 | $371.54 | $676.08 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | None | $645.65 | $645.65 | $707.95 |
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 $123.03 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $123.03 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $50.12 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $186.21 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $37.15 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $24.55 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $173.78 | $316.23 | $316.23 |
Where Iowa sits
The same service costs 5.2 times more in Alaska than in Texas. 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· 8th of 51
$550
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.