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 $2,630.27 Median $4,265.80 Typical High $7,244.36 | Facility | None | $2,630.27 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,584.89 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $5,888.44 Median $6,456.54 Typical High $7,762.47 | Facility | None | $5,888.44 | $6,456.54 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,801.89 | $4,570.88 |
Hally Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,548.82 | $2,691.53 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $2,398.83 Median $4,677.35 Typical High $17,378.01 | Facility | None | $2,398.83 | $4,677.35 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,715.35 Typical High $12,589.25 | Professional | None | $1,905.46 | $3,715.35 | $12,589.25 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,801.89 | $4,570.88 |
Midlands Setting Facility Modifier None Typical Low $5,888.44 Median $6,456.54 Typical High $7,762.47 | Facility | None | $5,888.44 | $6,456.54 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $11,748.98 | Professional | None | $3,235.94 | $3,630.78 | $11,748.98 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $3,715.35 | Professional | None | $1,548.82 | $2,884.03 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,511.89 | $4,570.88 |
Wellmark Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,162.28 | $3,715.35 |
4 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 54 · Surgery only Typical Low $1,122.02 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,122.02 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $229.09 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $151.36 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,819.70 | $1,819.70 |
Where Iowa sits
The same service costs 7.8 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· 9th of 51
$3,236
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.