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 $1,318.26 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,318.26 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $776.25 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,288.25 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,548.82 | $1,737.80 | $2,398.83 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,258.93 Typical High $2,187.76 | Professional | None | $758.58 | $1,258.93 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,148.15 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,778.28 Typical High $6,309.57 | Professional | None | $891.25 | $1,778.28 | $6,309.57 |
Midlands 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 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,318.26 | $2,041.74 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,238.72 | Professional | None | $794.33 | $1,230.27 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
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 $389.05 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $389.05 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $154.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $575.44 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $77.62 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $537.03 | $933.25 | $933.25 |
Where Iowa sits
The same service costs 7.2 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
$1,738
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.