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 $1,023.29 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,023.29 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,258.93 | Professional | None | $645.65 | $1,023.29 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,905.46 | Facility | None | $1,000.00 | $1,174.90 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,698.24 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,659.59 | Professional | None | $588.84 | $1,122.02 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $4,570.88 | Facility | None | $1,047.13 | $1,737.80 | $4,570.88 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $6,760.83 | Professional | None | $954.99 | $1,659.59 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,548.82 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,949.84 | Facility | None | $851.14 | $1,258.93 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,778.28 | $2,238.72 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,995.26 | Professional | None | $691.83 | $1,096.48 | $1,995.26 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,380.38 | $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 $323.59 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $323.59 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $204.17 Typical High $251.19 | Professional | 53 · Discontinued | $128.82 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $758.58 Typical High $954.99 | Professional | 54 · Surgery only | $478.63 | $758.58 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $151.36 Typical High $190.55 | Professional | 55 · Aftercare only | $95.50 | $151.36 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $64.57 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $707.95 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $446.68 | $707.95 | $891.25 |
Where Iowa sits
The same service costs 5.6 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
$1,445
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.