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 $165.96 Median $2,238.72 Typical High $6,606.93 | Facility | None | $165.96 | $2,238.72 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $331.13 | Professional | None | $117.49 | $165.96 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $134.90 Typical High $165.96 | Facility | None | $100.00 | $134.90 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $346.74 | Professional | None | $251.19 | $275.42 | $346.74 |
Hally Health Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $371.54 | Professional | None | $112.20 | $173.78 | $371.54 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $354.81 Typical High $1,148.15 | Facility | None | $138.04 | $354.81 | $1,148.15 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $1,096.48 | Professional | None | $169.82 | $331.13 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $346.74 | Professional | None | $234.42 | $295.12 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $165.96 | Facility | None | $97.72 | $125.89 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $426.58 | Professional | None | $234.42 | $338.84 | $426.58 |
United Setting Facility Modifier None Typical Low $223.87 Median $831.76 Typical High $1,995.26 | Facility | None | $223.87 | $831.76 | $1,995.26 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $371.54 | Professional | None | $128.82 | $204.17 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $371.54 | Professional | None | $218.78 | $257.04 | $371.54 |
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 $56.23 Median $83.18 Typical High $104.71 | Professional | 52 · Reduced service | $56.23 | $83.18 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.11 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $33.11 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $125.89 Typical High $154.88 | Professional | 54 · Surgery only | $85.11 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.12 Typical High $30.90 | Professional | 55 · Aftercare only | $16.98 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.60 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.22 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $117.49 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $79.43 | $117.49 | $144.54 |
Where Iowa sits
The same service costs 3.9 times more in Alaska than in Florida. 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.