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 $851.14 Median $4,265.80 Typical High $7,244.36 | Facility | None | $851.14 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $851.14 Typical High $851.14 | Professional | None | $501.19 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $645.65 Typical High $912.01 | Facility | None | $107.15 | $645.65 | $912.01 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,047.13 | $1,148.15 | $1,513.56 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $831.76 Typical High $1,412.54 | Professional | None | $501.19 | $831.76 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $1,174.90 Typical High $3,890.45 | Facility | None | $602.56 | $1,174.90 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $4,265.80 | Professional | None | $602.56 | $1,122.02 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,380.38 | Professional | None | $977.24 | $1,148.15 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $117.49 Median $645.65 Typical High $912.01 | Facility | None | $117.49 | $645.65 | $912.01 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,778.28 | Professional | None | $933.25 | $1,258.93 | $1,778.28 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,659.59 Typical High $4,073.80 | Facility | None | $501.19 | $1,659.59 | $4,073.80 |
United Setting Professional Modifier None Typical Low $537.03 Median $812.83 Typical High $1,479.11 | Professional | None | $537.03 | $812.83 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,071.52 | $1,258.93 |
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 $251.19 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $251.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $100.00 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $371.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $74.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $50.12 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $346.74 | $602.56 | $602.56 |
Where Iowa sits
The same service costs 6.3 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
$1,072
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.