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 $1,174.90 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,174.90 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $1,174.90 | Professional | None | $676.08 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $4,897.79 Typical High $6,309.57 | Facility | None | $1,778.28 | $4,897.79 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,584.89 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,862.09 | Professional | None | $676.08 | $1,096.48 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $2,041.74 Typical High $14,454.40 | Facility | None | $870.96 | $2,041.74 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,548.82 Typical High $7,585.78 | Professional | None | $831.76 | $1,548.82 | $7,585.78 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,584.89 | $1,862.09 |
Midlands Setting Facility Modifier None Typical Low $1,905.46 Median $4,786.30 Typical High $6,309.57 | Facility | None | $1,905.46 | $4,786.30 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,698.24 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $15,488.17 | Facility | None | $1,258.93 | $3,630.78 | $15,488.17 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $2,041.74 | Professional | None | $758.58 | $1,174.90 | $2,041.74 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,445.44 | $1,737.80 |
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 $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $338.84 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $134.90 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $512.86 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $102.33 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $67.61 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $478.63 | $812.83 | $812.83 |
Where Iowa sits
The same service costs 17.4 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
$1,549
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.