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 $602.56 Median $4,897.79 Typical High $7,244.36 | Facility | None | $602.56 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $588.84 Typical High $812.83 | Professional | None | $371.54 | $588.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,230.27 Typical High $1,445.44 | Facility | None | $630.96 | $1,230.27 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $1,258.93 | Professional | None | $831.76 | $954.99 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $691.83 Typical High $1,071.52 | Professional | None | $338.84 | $691.83 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $1,288.25 Typical High $3,981.07 | Facility | None | $691.83 | $1,288.25 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $3,890.45 | Professional | None | $645.65 | $1,023.29 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,258.93 | Professional | None | $707.95 | $977.24 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $1,445.44 | Facility | None | $676.08 | $1,230.27 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $1,348.96 | Professional | None | $724.44 | $1,071.52 | $1,348.96 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,288.25 | Professional | None | $407.38 | $691.83 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $1,258.93 | Professional | None | $707.95 | $831.76 | $1,258.93 |
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 $186.21 Median $295.12 Typical High $407.38 | Professional | 52 · Reduced service | $186.21 | $295.12 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $117.49 Typical High $162.18 | Professional | 53 · Discontinued | $74.13 | $117.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $616.60 | Professional | 54 · Surgery only | $281.84 | $446.68 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $89.13 Typical High $123.03 | Professional | 55 · Aftercare only | $56.23 | $89.13 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $58.88 Typical High $81.28 | Professional | 56 · Pre-op care only | $37.15 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $416.87 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $263.03 | $416.87 | $575.44 |
Where Iowa sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 4th of 51
$933
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.