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 $4,073.80 Median $5,011.87 Typical High $7,244.36 | Facility | None | $4,073.80 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $4,073.80 | Professional | None | $2,398.83 | $4,073.80 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,344.23 | Facility | None | $1,513.56 | $1,819.70 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $5,888.44 Median $6,165.95 Typical High $7,585.78 | Professional | None | $5,888.44 | $6,165.95 | $7,585.78 |
Hally Health Setting Professional Modifier None Typical Low $2,454.71 Median $3,801.89 Typical High $6,606.93 | Professional | None | $2,454.71 | $3,801.89 | $6,606.93 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,047.13 | $3,467.37 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $3,090.30 Median $5,754.40 Typical High $8,511.38 | Professional | None | $3,090.30 | $5,754.40 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $7,413.10 | Professional | None | $5,888.44 | $5,888.44 | $7,413.10 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $2,344.23 | Facility | None | $1,202.26 | $1,819.70 | $2,344.23 |
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 $2,818.38 Median $3,981.07 Typical High $7,413.10 | Professional | None | $2,818.38 | $3,981.07 | $7,413.10 |
Wellmark Setting Professional Modifier None Typical Low $4,466.84 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,466.84 | $4,677.35 | $4,677.35 |
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 $1,202.26 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,202.26 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $478.63 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,778.28 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $363.08 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $239.88 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,884.03 | $2,884.03 |
Where Iowa sits
The same service costs 15.8 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· 9th of 51
$4,365
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.