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 $1,412.54 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,412.54 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,412.54 Typical High $1,412.54 | Professional | None | $831.76 | $1,412.54 | $1,412.54 |
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 $1,905.46 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,137.96 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $2,137.96 | Professional | None | $851.14 | $1,258.93 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,258.93 | $2,290.87 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,047.13 | $1,862.09 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,398.83 | Professional | None | $2,089.30 | $2,089.30 | $2,398.83 |
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 $977.24 Median $1,318.26 Typical High $2,570.40 | Professional | None | $977.24 | $1,318.26 | $2,570.40 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,659.59 | $1,659.59 |
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 $416.87 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $416.87 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $165.96 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $616.60 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $83.18 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $575.44 | $1,000.00 | $1,000.00 |
Where Iowa sits
The same service costs 7.1 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
$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.