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 $1,380.38 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,380.38 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | None | $794.33 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,096.48 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,041.74 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $2,089.30 | Professional | None | $812.83 | $1,230.27 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $2,238.72 Typical High $7,079.46 | Facility | None | $1,047.13 | $2,238.72 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,737.80 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,290.87 | Professional | None | $2,041.74 | $2,041.74 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,230.27 | $1,995.26 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,762.47 | Facility | None | $1,258.93 | $3,630.78 | $7,762.47 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,454.71 | Professional | None | $933.25 | $1,288.25 | $2,454.71 |
Wellmark Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,513.56 | $1,621.81 | $1,621.81 |
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 $398.11 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $398.11 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $158.49 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $120.23 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $79.43 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $954.99 | $954.99 |
Where Iowa sits
The same service costs 7.6 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· 7th of 51
$1,820
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.