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 $338.84 Median $524.81 Typical High $794.33 | Professional | None | $338.84 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $1,380.38 | Facility | None | $831.76 | $1,148.15 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,230.27 | Professional | None | $724.44 | $977.24 | $1,230.27 |
Hally Health Setting Professional Modifier None Typical Low $302.00 Median $691.83 Typical High $954.99 | Professional | None | $302.00 | $691.83 | $954.99 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $4,466.84 | Facility | None | $630.96 | $1,230.27 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $3,801.89 | Professional | None | $512.86 | $1,000.00 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,174.90 | Professional | None | $616.60 | $933.25 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,380.38 | Facility | None | $851.14 | $1,148.15 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $954.99 Typical High $1,412.54 | Professional | None | $575.44 | $954.99 | $1,412.54 |
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 $354.81 Median $616.60 Typical High $1,202.26 | Professional | None | $354.81 | $616.60 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,348.96 | Professional | None | $660.69 | $776.25 | $1,348.96 |
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 $398.11 | Professional | 52 · Reduced service | $165.96 | $263.03 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $104.71 Typical High $158.49 | Professional | 53 · Discontinued | $66.07 | $104.71 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $398.11 Typical High $602.56 | Professional | 54 · Surgery only | $251.19 | $398.11 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $79.43 Typical High $120.23 | Professional | 55 · Aftercare only | $50.12 | $79.43 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $52.48 Typical High $79.43 | Professional | 56 · Pre-op care only | $33.11 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $371.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $234.42 | $371.54 | $562.34 |
Where Iowa sits
The same service costs 5.1 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
$832
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.