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 $1,513.56 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,513.56 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $1,513.56 | Professional | None | $870.96 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,090.30 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,862.09 | $2,187.76 | $2,691.53 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $2,398.83 | Professional | None | $891.25 | $1,412.54 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $11,748.98 | Facility | None | $1,288.25 | $2,570.40 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,041.74 Typical High $7,079.46 | Professional | None | $1,071.52 | $2,041.74 | $7,079.46 |
Midlands Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,511.89 | Professional | None | $1,862.09 | $2,187.76 | $2,511.89 |
Midlands Setting Facility Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,454.71 | $3,090.30 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,698.24 | $2,137.96 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,918.31 Typical High $13,803.84 | Facility | None | $2,630.27 | $6,918.31 | $13,803.84 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,630.27 | Professional | None | $954.99 | $1,445.44 | $2,630.27 |
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 $436.52 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $436.52 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $173.78 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $660.69 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $131.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $87.10 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $616.60 | $1,071.52 | $1,071.52 |
Where Iowa sits
The same service costs 14.1 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
$2,042
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.