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 $1,000.00 Median $4,168.69 Typical High $7,244.36 | Facility | None | $1,000.00 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,202.26 | Professional | None | $630.96 | $1,000.00 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,778.28 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $1,445.44 | Professional | None | $588.84 | $1,047.13 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $5,248.07 | Facility | None | $1,047.13 | $1,862.09 | $5,248.07 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,698.24 Typical High $4,786.30 | Professional | None | $933.25 | $1,698.24 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,778.28 | $2,137.96 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $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 $724.44 Median $1,071.52 Typical High $2,089.30 | Professional | None | $724.44 | $1,071.52 | $2,089.30 |
Wellmark Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,584.89 | Professional | None | $1,122.02 | $1,230.27 | $1,584.89 |
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 $316.23 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $316.23 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $125.89 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $478.63 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $181.97 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $63.10 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $851.14 |
Where Iowa sits
The same service costs 4.5 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
$1,479
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.