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 $1,174.90 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,174.90 | $2,344.23 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $933.25 Typical High $1,174.90 | Professional | None | $588.84 | $933.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $2,187.76 | Facility | None | $954.99 | $1,737.80 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,659.59 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,348.96 | Professional | None | $562.34 | $1,000.00 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $5,248.07 | Facility | None | $977.24 | $1,737.80 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,584.89 Typical High $4,570.88 | Professional | None | $870.96 | $1,584.89 | $4,570.88 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,659.59 | $2,089.30 |
Midlands Setting Facility Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $2,187.76 | Facility | None | $1,071.52 | $1,698.24 | $2,187.76 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,949.84 | Professional | None | $660.69 | $1,000.00 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,174.90 | $1,548.82 |
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 $295.12 Median $467.74 Typical High $588.84 | Professional | 52 · Reduced service | $295.12 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $186.21 Typical High $234.42 | Professional | 53 · Discontinued | $117.49 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $707.95 Typical High $891.25 | Professional | 54 · Surgery only | $436.52 | $707.95 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $177.83 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $93.33 Typical High $117.49 | Professional | 56 · Pre-op care only | $58.88 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $660.69 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $407.38 | $660.69 | $831.76 |
Where Iowa sits
The same service costs 4.2 times more in Alaska than in Texas. 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
$1,413
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.