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 $1,096.48 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,096.48 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,318.26 | Professional | None | $691.83 | $1,096.48 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,041.74 Typical High $2,630.27 | Facility | None | $1,202.26 | $2,041.74 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,862.09 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,513.56 | Professional | None | $660.69 | $1,096.48 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $6,025.60 | Facility | None | $912.01 | $2,041.74 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,778.28 Typical High $5,248.07 | Professional | None | $851.14 | $1,778.28 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,862.09 | $2,187.76 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $2,630.27 | Facility | None | $1,202.26 | $1,995.26 | $2,630.27 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $7,762.47 | Facility | None | $724.44 | $3,090.30 | $7,762.47 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $2,137.96 | Professional | None | $776.25 | $1,122.02 | $2,137.96 |
Wellmark Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,445.44 | $1,862.09 |
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 $346.74 Median $549.54 Typical High $660.69 | Professional | 52 · Reduced service | $346.74 | $549.54 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $218.78 Typical High $263.03 | Professional | 53 · Discontinued | $138.04 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $524.81 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $109.65 Typical High $131.83 | Professional | 56 · Pre-op care only | $69.18 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $776.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $489.78 | $776.25 | $933.25 |
Where Iowa sits
The same service costs 4.9 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· 4th of 51
$1,622
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.