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 $2,137.96 Median $2,137.96 Typical High $2,691.53 | Facility | None | $2,137.96 | $2,137.96 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,318.26 | $2,137.96 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,737.80 | Facility | None | $1,230.27 | $1,513.56 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,801.89 | $4,570.88 |
Hally Health Setting Professional Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,230.27 | $2,290.87 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,412.54 | $4,168.69 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $2,238.72 Median $3,715.35 Typical High $12,302.69 | Professional | None | $2,238.72 | $3,715.35 | $12,302.69 |
Midlands Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,570.40 | $3,235.94 | $4,168.69 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $1,819.70 | Facility | None | $1,096.48 | $1,548.82 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $4,570.88 | Professional | None | $2,951.21 | $3,801.89 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,011.87 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,584.89 | $2,511.89 | $4,570.88 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $4,265.80 | Professional | None | $2,454.71 | $2,884.03 | $4,265.80 |
5 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 $660.69 Median $1,071.52 Typical High $1,348.96 | Professional | 52 · Reduced service | $660.69 | $1,071.52 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $426.58 Typical High $537.03 | Professional | 53 · Discontinued | $263.03 | $426.58 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $323.59 Typical High $407.38 | Professional | 55 · Aftercare only | $199.53 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $213.80 Typical High $269.15 | Professional | 56 · Pre-op care only | $131.83 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,479.11 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $933.25 | $1,479.11 | $1,862.09 |
Where Iowa sits
The same service costs 5.1 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· 4th of 51
$3,236
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.