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 $954.99 Median $5,248.07 Typical High $7,943.28 | Facility | None | $954.99 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $1,230.27 | Professional | None | $616.60 | $954.99 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $4,897.79 Typical High $5,888.44 | Facility | None | $1,380.38 | $4,897.79 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,348.96 | $1,659.59 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $1,047.13 Typical High $1,659.59 | Professional | None | $549.54 | $1,047.13 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $12,589.25 | Facility | None | $1,023.29 | $2,187.76 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,548.82 Typical High $10,000.00 | Professional | None | $954.99 | $1,548.82 | $10,000.00 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,148.15 | $1,513.56 | $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 $1,288.25 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,698.24 | $2,238.72 |
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 $676.08 Median $1,122.02 Typical High $1,949.84 | Professional | None | $676.08 | $1,122.02 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,348.96 | $1,949.84 |
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 $309.03 Median $478.63 Typical High $616.60 | Professional | 52 · Reduced service | $309.03 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $190.55 Typical High $245.47 | Professional | 53 · Discontinued | $123.03 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $457.09 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $144.54 Typical High $186.21 | Professional | 55 · Aftercare only | $91.20 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $95.50 Typical High $123.03 | Professional | 56 · Pre-op care only | $61.66 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $870.96 |
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· 6th of 51
$1,479
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.