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 $1,348.96 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,348.96 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,348.96 | Professional | None | $794.33 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $5,128.61 Typical High $9,772.37 | Facility | None | $1,949.84 | $5,128.61 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,905.46 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $776.25 Median $1,288.25 Typical High $2,344.23 | Professional | None | $776.25 | $1,288.25 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $14,454.40 | Facility | None | $1,479.11 | $3,467.37 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $13,182.57 | Professional | None | $1,000.00 | $1,862.09 | $13,182.57 |
Midlands Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,905.46 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $2,951.21 Median $5,128.61 Typical High $9,772.37 | Facility | None | $2,951.21 | $5,128.61 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,584.89 | $1,905.46 | $3,019.95 |
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 $870.96 Median $1,318.26 Typical High $2,398.83 | Professional | None | $870.96 | $1,318.26 | $2,398.83 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,584.89 | $1,905.46 |
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 $398.11 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $398.11 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $158.49 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $79.43 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $954.99 | $954.99 |
Where Iowa sits
The same service costs 17.8 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
$1,862
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.