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 $812.83 Median $1,412.54 Typical High $1,412.54 | Professional | None | $812.83 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,862.09 | $2,137.96 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $2,089.30 | Professional | None | $831.76 | $1,258.93 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,348.96 | $2,238.72 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,047.13 | $1,819.70 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,089.30 | $2,511.89 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,511.89 | Professional | None | $954.99 | $1,318.26 | $2,511.89 |
Wellmark Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,548.82 | $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 $407.38 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $407.38 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $162.18 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $123.03 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $81.28 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $575.44 | $977.24 | $977.24 |
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· 6th 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.