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 $851.14 Median $6,760.83 Typical High $10,471.29 | Facility | None | $851.14 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $851.14 Typical High $1,023.29 | Professional | None | $549.54 | $851.14 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $4,168.69 | Facility | None | $1,778.28 | $2,454.71 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,445.44 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,548.82 | Professional | None | $489.78 | $891.25 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $7,413.10 | Facility | None | $1,023.29 | $1,862.09 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $5,754.40 | Professional | None | $891.25 | $1,412.54 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,230.27 | $1,621.81 |
Midlands Setting Facility Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $4,168.69 | Facility | None | $1,659.59 | $2,454.71 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,584.89 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,862.09 | Professional | None | $630.96 | $977.24 | $1,862.09 |
Wellmark Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,584.89 | Professional | None | $1,023.29 | $1,202.26 | $1,584.89 |
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 $269.15 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $269.15 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $169.82 Typical High $204.17 | Professional | 53 · Discontinued | $109.65 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $645.65 Typical High $758.58 | Professional | 54 · Surgery only | $407.38 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $85.11 Typical High $102.33 | Professional | 56 · Pre-op care only | $53.70 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $602.56 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $380.19 | $602.56 | $707.95 |
Where Iowa sits
The same service costs 6.2 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· 5th of 51
$1,259
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.