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 $512.86 Median $5,011.87 Typical High $7,943.28 | Facility | None | $512.86 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $776.25 | Professional | None | $407.38 | $512.86 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,290.87 | Facility | None | $1,380.38 | $1,778.28 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $794.33 Typical High $1,148.15 | Professional | None | $389.05 | $794.33 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $489.78 Typical High $776.25 | Professional | None | $263.03 | $489.78 | $776.25 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,258.93 Typical High $5,754.40 | Facility | None | $630.96 | $1,258.93 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $954.99 Typical High $3,388.44 | Professional | None | $588.84 | $954.99 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,148.15 | Professional | None | $660.69 | $794.33 | $1,148.15 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $2,290.87 | Facility | None | $1,202.26 | $1,905.46 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,548.13 Typical High $7,413.10 | Facility | None | $1,258.93 | $3,548.13 | $7,413.10 |
United Setting Professional Modifier None Typical Low $331.13 Median $645.65 Typical High $1,202.26 | Professional | None | $331.13 | $645.65 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $1,122.02 | Professional | None | $549.54 | $645.65 | $1,122.02 |
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 $204.17 Median $257.04 Typical High $389.05 | Professional | 52 · Reduced service | $204.17 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $81.28 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $588.84 | Professional | 54 · Surgery only | $309.03 | $389.05 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $117.49 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $40.74 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $549.54 |
Where Iowa sits
The same service costs 5.5 times more in Alaska 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· 5th of 51
$813
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.