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 $776.25 Median $1,348.96 Typical High $1,348.96 | Professional | None | $776.25 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,754.23 Typical High $4,073.80 | Facility | None | $1,096.48 | $2,754.23 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,949.84 | $2,344.23 |
Hally Health Setting Professional Modifier None Typical Low $794.33 Median $1,288.25 Typical High $2,290.87 | Professional | None | $794.33 | $1,288.25 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,398.83 Typical High $8,912.51 | Facility | None | $1,412.54 | $2,398.83 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,905.46 Typical High $6,309.57 | Professional | None | $954.99 | $1,905.46 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,905.46 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $4,073.80 | Facility | None | $1,621.81 | $2,754.23 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,905.46 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
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 $154.88 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $154.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $588.84 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $117.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $77.62 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $549.54 | $933.25 | $933.25 |
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· 4th 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.