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 $1,318.26 Median $3,090.30 Typical High $6,760.83 | Facility | None | $1,318.26 | $3,090.30 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,318.26 Typical High $1,995.26 | Professional | None | $831.76 | $1,318.26 | $1,995.26 |
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 $1,698.24 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,238.72 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $776.25 | $1,288.25 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $2,238.72 Typical High $5,495.41 | Facility | None | $1,047.13 | $2,238.72 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $2,187.76 Typical High $6,309.57 | Professional | None | $1,000.00 | $2,187.76 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,238.72 | $2,691.53 |
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 $933.25 Median $1,348.96 Typical High $2,691.53 | Professional | None | $933.25 | $1,348.96 | $2,691.53 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,621.81 | $1,995.26 |
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 $407.38 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $407.38 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $162.18 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $616.60 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $123.03 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $81.28 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $575.44 | $912.01 | $1,071.52 |
Where Iowa sits
The same service costs 4.4 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
$1,905
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.