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 $630.96 Median $3,388.44 Typical High $6,760.83 | Facility | None | $630.96 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $870.96 | Professional | None | $398.11 | $630.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,238.72 Typical High $2,884.03 | Facility | None | $954.99 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,445.44 | Professional | None | $851.14 | $1,023.29 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $645.65 Typical High $933.25 | Professional | None | $338.84 | $645.65 | $933.25 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,412.54 Typical High $7,244.36 | Facility | None | $776.25 | $1,412.54 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $977.24 Typical High $3,019.95 | Professional | None | $588.84 | $977.24 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,412.54 | Professional | None | $851.14 | $1,023.29 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $2,884.03 | Facility | None | $1,148.15 | $2,238.72 | $2,884.03 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $8,709.64 | Facility | None | $724.44 | $3,090.30 | $8,709.64 |
United Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $1,258.93 | Professional | None | $416.87 | $645.65 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,174.90 | Professional | None | $741.31 | $812.83 | $1,174.90 |
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 $316.23 Typical High $436.52 | Professional | 52 · Reduced service | $199.53 | $316.23 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $125.89 Typical High $173.78 | Professional | 53 · Discontinued | $79.43 | $125.89 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $467.74 Typical High $660.69 | Professional | 54 · Surgery only | $295.12 | $467.74 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $93.33 Typical High $131.83 | Professional | 55 · Aftercare only | $60.26 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $616.60 |
Where Iowa sits
The same service costs 4.4 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· 5th 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.