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 $1,148.15 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,148.15 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,148.15 Typical High $1,148.15 | Professional | None | $660.69 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $4,365.16 | Facility | None | $3,162.28 | $3,981.07 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,445.44 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $660.69 Median $1,096.48 Typical High $1,737.80 | Professional | None | $660.69 | $1,096.48 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $1,698.24 Typical High $9,332.54 | Facility | None | $1,000.00 | $1,698.24 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $5,370.32 | Professional | None | $812.83 | $1,380.38 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $4,365.16 | Facility | None | $3,162.28 | $3,981.07 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,621.81 | $2,511.89 |
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 $707.95 Median $1,071.52 Typical High $1,949.84 | Professional | None | $707.95 | $1,071.52 | $1,949.84 |
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 $331.13 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $331.13 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $131.83 | $229.09 | $229.09 |
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 $100.00 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $100.00 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $66.07 | $114.82 | $114.82 |
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 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· 8th of 51
$1,413
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.