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 $1,202.26 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,202.26 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,202.26 | Professional | None | $707.95 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,754.23 Typical High $3,467.37 | Facility | None | $1,096.48 | $2,754.23 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,479.11 | $1,737.80 | $2,137.96 |
Hally Health Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $2,511.89 | Professional | None | $707.95 | $1,258.93 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,511.89 Typical High $8,912.51 | Facility | None | $1,412.54 | $2,511.89 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,778.28 Typical High $6,309.57 | Professional | None | $870.96 | $1,778.28 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,737.80 | $2,089.30 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,884.03 Typical High $3,630.78 | Facility | None | $1,621.81 | $2,884.03 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,737.80 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $10,715.19 | Facility | None | $1,584.89 | $4,897.79 | $10,715.19 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $2,089.30 | Professional | None | $758.58 | $1,148.15 | $2,089.30 |
Wellmark Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,513.56 | $1,778.28 |
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 $354.81 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $354.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $141.25 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $524.81 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $104.71 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $70.79 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $489.78 | $851.14 | $851.14 |
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
$1,738
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.