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 $1,621.81 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,621.81 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,621.81 Typical High $1,621.81 | Professional | None | $954.99 | $1,621.81 | $1,621.81 |
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 $1,995.26 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,137.96 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,754.23 | Professional | None | $954.99 | $1,584.89 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $9,332.54 | Facility | None | $1,380.38 | $2,398.83 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $8,511.38 | Professional | None | $1,174.90 | $2,089.30 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $2,630.27 | Professional | None | $1,819.70 | $2,137.96 | $2,630.27 |
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 $1,778.28 Median $2,290.87 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,290.87 | $3,548.13 |
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 $1,023.29 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,584.89 | $2,818.38 |
Wellmark Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,995.26 | $1,995.26 | $2,344.23 |
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 $478.63 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $478.63 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $190.55 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $707.95 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $141.25 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $95.50 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $660.69 | $1,148.15 | $1,148.15 |
Where Iowa sits
The same service costs 18.2 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
$2,089
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.