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 $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,348.96 Typical High $2,238.72 | Professional | None | $398.11 | $1,348.96 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $3,162.28 | Facility | None | $1,096.48 | $2,691.53 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $2,754.23 Typical High $4,168.69 | Professional | None | $660.69 | $2,754.23 | $4,168.69 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $1,819.70 Typical High $2,290.87 | Professional | None | $309.03 | $1,819.70 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,019.95 Typical High $8,317.64 | Facility | None | $851.14 | $3,019.95 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $2,570.40 Typical High $5,370.32 | Professional | None | $645.65 | $2,570.40 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $3,090.30 Typical High $4,073.80 | Professional | None | $660.69 | $3,090.30 | $4,073.80 |
Midlands Setting Facility Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,630.27 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $4,677.35 | Professional | None | $602.56 | $1,122.02 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,288.25 Typical High $3,890.45 | Professional | None | $371.54 | $1,288.25 | $3,890.45 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $3,890.45 | Professional | None | $660.69 | $776.25 | $3,890.45 |
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 $199.53 Median $263.03 Typical High $1,096.48 | Professional | 52 · Reduced service | $199.53 | $263.03 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $107.15 Typical High $446.68 | Professional | 53 · Discontinued | $81.28 | $107.15 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $398.11 Typical High $1,659.59 | Professional | 54 · Surgery only | $302.00 | $398.11 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $331.13 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $52.48 Typical High $223.87 | Professional | 56 · Pre-op care only | $39.81 | $52.48 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $371.54 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $281.84 | $371.54 | $1,548.82 |
Where Iowa sits
The same service costs 5.8 times more in Alaska than in Nebraska. 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· 5th of 51
$2,239
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.