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 $1,584.89 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,584.89 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,584.89 Typical High $1,584.89 | Professional | None | $933.25 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,096.48 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,949.84 | $2,187.76 | $2,818.38 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,621.81 Typical High $3,311.31 | Professional | None | $933.25 | $1,621.81 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $17,378.01 | Facility | None | $1,584.89 | $2,818.38 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $7,413.10 | Professional | None | $1,148.15 | $2,137.96 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,187.76 | $2,570.40 |
Midlands Setting Facility Modifier None Typical Low $1,905.46 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,905.46 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,949.84 | $2,238.72 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $19,054.61 | Facility | None | $1,380.38 | $4,365.16 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,548.82 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,949.84 | $1,949.84 | $2,290.87 |
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 $457.09 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $457.09 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $186.21 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $691.83 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $138.04 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $93.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $645.65 | $1,122.02 | $1,122.02 |
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
$2,138
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.