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 $602.56 Median $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $524.81 Typical High $707.95 | Professional | None | $331.13 | $524.81 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $3,388.44 | Facility | None | $1,096.48 | $2,454.71 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,071.52 | Professional | None | $741.31 | $912.01 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $602.56 Typical High $891.25 | Professional | None | $302.00 | $602.56 | $891.25 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,348.96 Typical High $8,511.38 | Facility | None | $724.44 | $1,348.96 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $3,388.44 | Professional | None | $512.86 | $891.25 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,000.00 | Professional | None | $630.96 | $851.14 | $1,000.00 |
Midlands Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,318.26 | $2,454.71 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,258.93 | Professional | None | $630.96 | $912.01 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,011.87 | $10,715.19 |
United Setting Professional Modifier None Typical Low $346.74 Median $562.34 Typical High $1,023.29 | Professional | None | $346.74 | $562.34 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,096.48 | Professional | None | $616.60 | $724.44 | $1,096.48 |
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 $165.96 Median $263.03 Typical High $354.81 | Professional | 52 · Reduced service | $165.96 | $263.03 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $104.71 Typical High $141.25 | Professional | 53 · Discontinued | $66.07 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $524.81 | Professional | 54 · Surgery only | $245.47 | $389.05 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $77.62 Typical High $104.71 | Professional | 55 · Aftercare only | $50.12 | $77.62 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $70.79 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $363.08 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $229.09 | $363.08 | $489.78 |
Where Iowa sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$813
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.