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 $660.69 Median $1,122.02 Typical High $1,122.02 | Professional | None | $660.69 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,090.30 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,479.11 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,819.70 | Professional | None | $660.69 | $1,071.52 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $9,332.54 | Facility | None | $977.24 | $1,862.09 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $5,248.07 | Professional | None | $776.25 | $1,445.44 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,479.11 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,090.30 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,659.59 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $5,495.41 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,495.41 | $11,220.18 |
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 $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $323.59 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $97.72 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $66.07 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $457.09 | $794.33 | $794.33 |
Where Iowa sits
The same service costs 19.5 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· 7th of 51
$1,445
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.