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 $1,348.96 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,348.96 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,348.96 Typical High $1,348.96 | Professional | None | $794.33 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $6,165.95 Typical High $7,762.47 | Facility | None | $1,096.48 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,949.84 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,318.26 Typical High $2,290.87 | Professional | None | $794.33 | $1,318.26 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,677.35 Typical High $17,378.01 | Facility | None | $1,258.93 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,905.46 Typical High $6,309.57 | Professional | None | $977.24 | $1,905.46 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,659.59 | $1,949.84 | $2,344.23 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $6,309.57 Typical High $7,244.36 | Facility | None | $4,073.80 | $6,309.57 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,659.59 | $1,949.84 | $2,884.03 |
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 $851.14 Median $1,288.25 Typical High $2,344.23 | Professional | None | $851.14 | $1,288.25 | $2,344.23 |
Wellmark Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
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 $389.05 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $389.05 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $158.49 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $588.84 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $79.43 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $549.54 | $954.99 | $954.99 |
Where Iowa sits
The same service costs 8.1 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
$1,905
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.