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 $316.23 Median $3,388.44 Typical High $6,760.83 | Facility | None | $316.23 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $426.58 | Professional | None | $199.53 | $275.42 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $3,388.44 | Facility | None | $954.99 | $2,818.38 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $575.44 | Professional | None | $416.87 | $489.78 | $575.44 |
Hally Health Setting Professional Modifier None Typical Low $173.78 Median $323.59 Typical High $575.44 | Professional | None | $173.78 | $323.59 | $575.44 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $1,071.52 Typical High $7,762.47 | Facility | None | $363.08 | $1,071.52 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $1,380.38 | Professional | None | $302.00 | $501.19 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $575.44 | Professional | None | $416.87 | $478.63 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $1,174.90 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,174.90 | $2,754.23 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $645.65 | Professional | None | $363.08 | $489.78 | $645.65 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $9,332.54 | Facility | None | $1,258.93 | $3,630.78 | $9,332.54 |
United Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $588.84 | Professional | None | $213.80 | $331.13 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $512.86 | Professional | None | $338.84 | $398.11 | $512.86 |
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 $97.72 Median $138.04 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $144.54 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $41.69 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $134.90 | $190.55 | $218.78 |
Where Iowa sits
The same service costs 5.9 times more in Oklahoma than in Utah. 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· 4th of 51
$479
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.