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 $933.25 Median $3,388.44 Typical High $6,760.83 | Facility | None | $933.25 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $933.25 Typical High $1,122.02 | Professional | None | $602.56 | $933.25 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,096.48 Typical High $1,288.25 | Facility | None | $630.96 | $1,096.48 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,412.54 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,318.26 | Professional | None | $524.81 | $758.58 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $1,584.89 Typical High $4,466.84 | Facility | None | $741.31 | $1,584.89 | $4,466.84 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,513.56 Typical High $5,248.07 | Professional | None | $575.44 | $1,513.56 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,348.96 | $1,621.81 |
Midlands Setting Facility Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,380.38 | Facility | None | $794.33 | $1,148.15 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,621.81 | $1,949.84 |
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 $602.56 Median $933.25 Typical High $1,778.28 | Professional | None | $602.56 | $933.25 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,380.38 | $1,778.28 |
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 $302.00 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $302.00 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $186.21 Typical High $223.87 | Professional | 53 · Discontinued | $120.23 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $691.83 Typical High $831.76 | Professional | 54 · Surgery only | $457.09 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $138.04 Typical High $165.96 | Professional | 55 · Aftercare only | $91.20 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $93.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $60.26 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $645.65 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $426.58 | $645.65 | $776.25 |
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
$1,318
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.