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 $1,096.48 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,096.48 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,096.48 | Professional | None | $645.65 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,096.48 | $3,019.95 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,584.89 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,737.80 | Professional | None | $645.65 | $1,023.29 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $1,949.84 Typical High $8,317.64 | Facility | None | $1,000.00 | $1,949.84 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,479.11 Typical High $5,754.40 | Professional | None | $776.25 | $1,479.11 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,348.96 | $1,584.89 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $3,019.95 Typical High $4,168.69 | Facility | None | $1,621.81 | $3,019.95 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,584.89 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
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 $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $128.82 | $218.78 | $218.78 |
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 $95.50 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $95.50 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $64.57 | $109.65 | $109.65 |
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 8.5 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· 6th of 51
$1,479
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.