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 $977.24 Median $4,897.79 Typical High $7,244.36 | Facility | None | $977.24 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,202.26 | Professional | None | $645.65 | $977.24 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $6,309.57 | Facility | None | $1,288.25 | $4,897.79 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,513.56 | $1,862.09 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $1,479.11 | Professional | None | $562.34 | $954.99 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $2,137.96 Typical High $12,589.25 | Facility | None | $1,023.29 | $2,137.96 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $5,754.40 | Professional | None | $851.14 | $1,621.81 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,479.11 | $1,778.28 |
Midlands Setting Facility Modifier None Typical Low $1,778.28 Median $4,897.79 Typical High $5,888.44 | Facility | None | $1,778.28 | $4,897.79 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,737.80 | $2,187.76 |
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 $676.08 Median $1,023.29 Typical High $1,949.84 | Professional | None | $676.08 | $1,023.29 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,380.38 | $1,862.09 |
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 $316.23 Median $489.78 Typical High $602.56 | Professional | 52 · Reduced service | $316.23 | $489.78 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $194.98 Typical High $239.88 | Professional | 53 · Discontinued | $128.82 | $194.98 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $741.31 Typical High $912.01 | Professional | 54 · Surgery only | $478.63 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $147.91 Typical High $181.97 | Professional | 55 · Aftercare only | $95.50 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $97.72 Typical High $120.23 | Professional | 56 · Pre-op care only | $64.57 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $691.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $446.68 | $691.83 | $851.14 |
Where Iowa sits
The same service costs 6.6 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· 5th 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.