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 $954.99 Median $4,265.80 Typical High $7,244.36 | Facility | None | $954.99 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | None | $549.54 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,290.87 | Facility | None | $1,096.48 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,380.38 | $1,659.59 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $977.24 Typical High $1,949.84 | Professional | None | $549.54 | $977.24 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $5,370.32 | Facility | None | $1,122.02 | $1,621.81 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,380.38 Typical High $5,370.32 | Professional | None | $676.08 | $1,380.38 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,348.96 | $1,621.81 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,344.23 | Facility | None | $1,096.48 | $1,513.56 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,380.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $6,309.57 | Facility | None | $1,258.93 | $3,235.94 | $6,309.57 |
United Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,621.81 | Professional | None | $588.84 | $891.25 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,202.26 | $1,202.26 | $1,412.54 |
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 $275.42 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $275.42 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $109.65 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $416.87 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $83.18 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $54.95 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $389.05 | $660.69 | $660.69 |
Where Iowa sits
The same service costs 7.4 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
$1,349
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.