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 $1,071.52 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,071.52 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $1,548.82 | Professional | None | $676.08 | $1,071.52 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,897.79 Typical High $5,888.44 | Facility | None | $954.99 | $4,897.79 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,819.70 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,778.28 | Professional | None | $616.60 | $1,148.15 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $12,589.25 | Facility | None | $1,122.02 | $2,137.96 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $5,888.44 | Professional | None | $1,071.52 | $1,778.28 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,548.82 | $1,995.26 |
Midlands Setting Facility Modifier None Typical Low $2,951.21 Median $4,786.30 Typical High $5,888.44 | Facility | None | $2,951.21 | $4,786.30 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,819.70 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,584.89 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,238.72 | Professional | None | $758.58 | $1,174.90 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,513.56 | $2,041.74 |
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 $338.84 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $338.84 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $134.90 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $512.86 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $162.18 Typical High $190.55 | Professional | 55 · Aftercare only | $102.33 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $67.61 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $478.63 | $741.31 | $891.25 |
Where Iowa sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 5th of 51
$1,549
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.