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 $1,071.52 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,071.52 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,071.52 | Professional | None | $616.60 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,888.44 | $7,079.46 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,548.82 | $1,862.09 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,819.70 | Professional | None | $630.96 | $1,023.29 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $15,848.93 | Facility | None | $954.99 | $1,862.09 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,513.56 Typical High $5,011.87 | Professional | None | $758.58 | $1,513.56 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,318.26 | $1,513.56 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $5,888.44 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,888.44 | $7,079.46 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,513.56 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $19,054.61 | Facility | None | $1,380.38 | $4,365.16 | $19,054.61 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,862.09 | Professional | None | $660.69 | $1,023.29 | $1,862.09 |
Wellmark Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,318.26 | $1,548.82 |
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 $309.03 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $309.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $467.74 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $93.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $61.66 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $436.52 | $741.31 | $741.31 |
Where Iowa sits
The same service costs 7.4 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· 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.