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 $1,445.44 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,445.44 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,445.44 Typical High $1,445.44 | Professional | None | $831.76 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,862.09 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,348.96 Typical High $2,187.76 | Professional | None | $831.76 | $1,348.96 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $8,912.51 | Facility | None | $1,380.38 | $2,454.71 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,905.46 Typical High $6,760.83 | Professional | None | $977.24 | $1,905.46 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,344.23 | Professional | None | $1,584.89 | $1,862.09 | $2,344.23 |
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 $1,445.44 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,187.76 | $3,235.94 |
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 $891.25 Median $1,348.96 Typical High $2,511.89 | Professional | None | $891.25 | $1,348.96 | $2,511.89 |
Wellmark Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
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 $416.87 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $416.87 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $165.96 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $630.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $125.89 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $83.18 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $588.84 | $1,000.00 | $1,000.00 |
Where Iowa sits
The same service costs 7.6 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
$1,862
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.