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 $1,584.89 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,584.89 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,584.89 Typical High $1,584.89 | Professional | None | $912.01 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $6,309.57 | Facility | None | $4,786.30 | $5,754.40 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,238.72 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,398.83 | Professional | None | $933.25 | $1,412.54 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $13,182.57 | Facility | None | $1,659.59 | $2,818.38 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $8,511.38 | Professional | None | $1,148.15 | $2,089.30 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,905.46 | $2,238.72 | $2,754.23 |
Midlands Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $6,309.57 | Facility | None | $4,786.30 | $5,754.40 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,905.46 | $2,187.76 | $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 $1,000.00 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,548.82 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
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 $457.09 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $457.09 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $181.97 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $691.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $138.04 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $91.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $645.65 | $1,096.48 | $1,096.48 |
Where Iowa sits
The same service costs 18.2 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
$2,042
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.