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 $1,230.27 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,230.27 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,230.27 Typical High $1,230.27 | Professional | None | $707.95 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $3,235.94 Typical High $4,073.80 | Facility | None | $1,288.25 | $3,235.94 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,698.24 | $1,862.09 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $724.44 Median $1,122.02 Typical High $1,819.70 | Professional | None | $724.44 | $1,122.02 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $9,772.37 | Facility | None | $1,288.25 | $2,344.23 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $2,454.71 | Professional | None | $891.25 | $1,621.81 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,819.70 | $1,819.70 | $2,187.76 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $3,090.30 Typical High $4,073.80 | Facility | None | $1,288.25 | $3,090.30 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,000.00 | Facility | None | $1,380.38 | $4,365.16 | $10,000.00 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,187.76 | Professional | None | $831.76 | $1,148.15 | $2,187.76 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,445.44 | $1,445.44 |
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 $354.81 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $354.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $141.25 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $537.03 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $107.15 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $70.79 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $501.19 | $851.14 | $851.14 |
Where Iowa sits
The same service costs 8.1 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
$1,778
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.