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 $1,479.11 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,479.11 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $1,479.11 | Professional | None | $870.96 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $7,585.78 Typical High $9,332.54 | Facility | None | $1,380.38 | $7,585.78 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,819.70 | $2,137.96 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $870.96 Median $1,479.11 Typical High $2,630.27 | Professional | None | $870.96 | $1,479.11 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,698.24 Median $4,677.35 Typical High $17,378.01 | Facility | None | $1,698.24 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $6,918.31 | Professional | None | $1,071.52 | $2,089.30 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,137.96 | $2,570.40 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $7,244.36 Typical High $9,332.54 | Facility | None | $4,073.80 | $7,244.36 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,089.30 | $3,388.44 |
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 $933.25 Median $1,445.44 Typical High $2,570.40 | Professional | None | $933.25 | $1,445.44 | $2,570.40 |
Wellmark Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | None | $1,819.70 | $1,819.70 | $2,137.96 |
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 $426.58 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $426.58 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $173.78 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $645.65 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $128.82 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $87.10 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $602.56 | $1,047.13 | $1,047.13 |
Where Iowa sits
The same service costs 7.9 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
$2,089
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.