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 Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Professional | None | $2,137.96 | $2,137.96 | $2,630.27 |
Hally Health Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,290.87 | Professional | None | $851.14 | $1,348.96 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $3,467.37 Typical High $17,378.01 | Facility | None | $1,202.26 | $3,467.37 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $6,760.83 | Professional | None | $1,047.13 | $1,905.46 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,454.71 | Professional | None | $1,778.28 | $2,089.30 | $2,454.71 |
Midlands Setting Facility Modifier None Typical Low $3,388.44 Median $6,606.93 Typical High $10,715.19 | Facility | None | $3,388.44 | $6,606.93 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,041.74 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,584.89 | $5,011.87 | $19,054.61 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,511.89 | Professional | None | $912.01 | $1,380.38 | $2,511.89 |
Wellmark Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
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 $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $125.89 | $218.78 | $218.78 |
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 17.4 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· 10th of 51
$1,778
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.