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 $676.08 Median $2,951.21 Typical High $6,760.83 | Facility | None | $676.08 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $676.08 Typical High $676.08 | Professional | None | $389.05 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,630.27 Typical High $3,235.94 | Facility | None | $645.65 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,174.90 | Professional | None | $794.33 | $977.24 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,071.52 | Professional | None | $389.05 | $616.60 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $1,659.59 Typical High $8,317.64 | Facility | None | $691.83 | $1,659.59 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $891.25 Typical High $3,162.28 | Professional | None | $467.74 | $891.25 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,148.15 | Professional | None | $831.76 | $933.25 | $1,148.15 |
Midlands Setting Facility Modifier None Typical Low $1,513.56 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,513.56 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,348.96 | Professional | None | $794.33 | $1,000.00 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $630.96 Typical High $1,148.15 | Professional | None | $416.87 | $630.96 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | None | $851.14 | $851.14 | $1,000.00 |
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 $194.98 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $194.98 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $77.62 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $58.88 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $38.90 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $275.42 | $467.74 | $467.74 |
Where Iowa sits
The same service costs 8.3 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
$933
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.