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 $1,548.82 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,548.82 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $1,548.82 | Professional | None | $891.25 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $7,079.46 Median $8,912.51 Typical High $9,772.37 | Facility | None | $7,079.46 | $8,912.51 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,290.87 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,818.38 | Professional | None | $954.99 | $1,584.89 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $9,772.37 | Facility | None | $1,380.38 | $2,630.27 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $11,481.54 | Professional | None | $1,148.15 | $2,238.72 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,949.84 | $2,290.87 | $2,754.23 |
Midlands Setting Facility Modifier None Typical Low $7,079.46 Median $8,912.51 Typical High $9,772.37 | Facility | None | $7,079.46 | $8,912.51 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,344.23 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,023.29 | $1,548.82 | $2,884.03 |
Wellmark Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | None | $2,041.74 | $2,041.74 | $2,454.71 |
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 $446.68 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $446.68 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $177.83 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $676.08 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $134.90 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $89.13 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $630.96 | $1,096.48 | $1,096.48 |
Where Iowa sits
The same service costs 14.8 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
$2,239
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.