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 $549.54 Median $5,011.87 Typical High $7,943.28 | Facility | None | $549.54 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $549.54 Typical High $724.44 | Professional | None | $338.84 | $549.54 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $66.07 | Facility | None | $61.66 | $61.66 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,288.25 | Professional | None | $812.83 | $1,071.52 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $831.76 | Professional | None | $323.59 | $602.56 | $831.76 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $912.01 Typical High $1,513.56 | Facility | None | $416.87 | $912.01 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $933.25 Typical High $2,691.53 | Professional | None | $426.58 | $933.25 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,288.25 | Professional | None | $812.83 | $977.24 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $66.07 Typical High $72.44 | Facility | None | $61.66 | $66.07 | $72.44 |
United Setting Facility Modifier None Typical Low $223.87 Median $954.99 Typical High $1,995.26 | Facility | None | $223.87 | $954.99 | $1,995.26 |
United Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,202.26 | Professional | None | $398.11 | $602.56 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $707.95 Typical High $933.25 | Professional | None | $630.96 | $707.95 | $933.25 |
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 $169.82 Median $275.42 Typical High $363.08 | Professional | 52 · Reduced service | $169.82 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $109.65 Typical High $144.54 | Professional | 53 · Discontinued | $67.61 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $416.87 Typical High $549.54 | Professional | 54 · Surgery only | $257.04 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $83.18 Typical High $109.65 | Professional | 55 · Aftercare only | $51.29 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $54.95 Typical High $72.44 | Professional | 56 · Pre-op care only | $33.88 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $389.05 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $239.88 | $389.05 | $512.86 |
Where Iowa sits
The same service costs 4.7 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· 6th 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.