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 $338.84 Median $3,388.44 Typical High $6,760.83 | Facility | None | $338.84 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $338.84 | Professional | None | $125.89 | $208.93 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $295.12 Typical High $389.05 | Facility | None | $245.47 | $295.12 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $588.84 | Professional | None | $295.12 | $380.19 | $588.84 |
Hally Health Setting Professional Modifier None Typical Low $114.82 Median $288.40 Typical High $426.58 | Professional | None | $114.82 | $288.40 | $426.58 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $549.54 Typical High $4,466.84 | Facility | None | $257.04 | $549.54 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $977.24 | Professional | None | $229.09 | $416.87 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $588.84 | Professional | None | $295.12 | $467.74 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $389.05 | Facility | None | $239.88 | $295.12 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $660.69 | Professional | None | $257.04 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $141.25 Median $288.40 Typical High $524.81 | Professional | None | $141.25 | $288.40 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $489.78 | Professional | None | $239.88 | $281.84 | $489.78 |
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 $63.10 Median $104.71 Typical High $165.96 | Professional | 52 · Reduced service | $63.10 | $104.71 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $41.69 Typical High $67.61 | Professional | 53 · Discontinued | $25.12 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $158.49 Typical High $251.19 | Professional | 54 · Surgery only | $95.50 | $158.49 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $31.62 Typical High $50.12 | Professional | 55 · Aftercare only | $19.05 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $20.89 Typical High $33.88 | Professional | 56 · Pre-op care only | $12.59 | $20.89 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $147.91 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $89.13 | $147.91 | $234.42 |
Where Iowa sits
The same service costs 3.9 times more in Oklahoma 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· 6th of 51
$363
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.