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 $1,122.02 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,122.02 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,122.02 | Professional | None | $645.65 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,495.41 | $7,079.46 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,548.82 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,905.46 | Professional | None | $645.65 | $1,122.02 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $9,332.54 | Facility | None | $1,174.90 | $1,905.46 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,584.89 Typical High $5,370.32 | Professional | None | $794.33 | $1,584.89 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,548.82 | $1,778.28 |
Midlands Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,495.41 | $7,079.46 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,348.96 | $1,584.89 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,905.46 | Professional | None | $691.83 | $1,047.13 | $1,905.46 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,380.38 | $1,380.38 | $1,621.81 |
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 $323.59 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $323.59 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $128.82 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $478.63 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $97.72 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $64.57 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $446.68 | $776.25 | $776.25 |
Where Iowa sits
The same service costs 8.7 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
$1,549
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.