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 $190.55 Median $5,011.87 Typical High $7,943.28 | Facility | None | $190.55 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $190.55 Typical High $281.84 | Professional | None | $114.82 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Facility | None | $61.66 | $61.66 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $398.11 | Professional | None | $257.04 | $323.59 | $398.11 |
Hally Health Setting Professional Modifier None Typical Low $102.33 Median $194.98 Typical High $309.03 | Professional | None | $102.33 | $194.98 | $309.03 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $338.84 Typical High $1,288.25 | Facility | None | $208.93 | $338.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $831.76 | Professional | None | $190.55 | $309.03 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $398.11 | Professional | None | $257.04 | $323.59 | $398.11 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $436.52 | Professional | None | $213.80 | $288.40 | $436.52 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $363.08 | Professional | None | $125.89 | $213.80 | $363.08 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | None | $199.53 | $234.42 | $338.84 |
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 $64.57 Median $95.50 Typical High $120.23 | Professional | 52 · Reduced service | $64.57 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $38.02 Typical High $48.98 | Professional | 53 · Discontinued | $25.70 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $181.97 | Professional | 54 · Surgery only | $95.50 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $36.31 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $19.05 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.88 | $19.05 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $131.83 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $89.13 | $131.83 | $169.82 |
Where Iowa sits
The same service costs 4.1 times more in Alaska 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· 3rd of 51
$288
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.