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 $1,148.15 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | None | $676.08 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $14,454.40 | Facility | None | $10,232.93 | $12,882.50 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,698.24 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $676.08 Median $1,096.48 Typical High $1,862.09 | Professional | None | $676.08 | $1,096.48 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $9,332.54 | Facility | None | $1,000.00 | $1,995.26 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,621.81 Typical High $5,495.41 | Professional | None | $812.83 | $1,621.81 | $5,495.41 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,659.59 | $1,905.46 |
Midlands Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $14,454.40 | Facility | None | $10,232.93 | $12,882.50 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,659.59 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $33,884.42 | Facility | None | $1,819.70 | $6,309.57 | $33,884.42 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,995.26 | Professional | None | $724.44 | $1,096.48 | $1,995.26 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,445.44 | $1,698.24 |
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 $338.84 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $338.84 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $134.90 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $501.19 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $100.00 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $67.61 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $467.74 | $812.83 | $812.83 |
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· 5th of 51
$1,622
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.