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 $1,995.26 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,995.26 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $4,897.79 Typical High $5,888.44 | Facility | None | $1,949.84 | $4,897.79 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,754.23 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,659.59 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,862.09 Median $3,467.37 Typical High $14,454.40 | Facility | None | $1,862.09 | $3,467.37 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $3,715.35 | Professional | None | $1,380.38 | $2,398.83 | $3,715.35 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,235.94 | Professional | None | $2,454.71 | $2,454.71 | $3,235.94 |
Midlands Setting Facility Modifier None Typical Low $2,951.21 Median $4,786.30 Typical High $5,888.44 | Facility | None | $2,951.21 | $4,786.30 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,584.89 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,778.28 | $3,311.31 |
Wellmark Setting Professional Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,238.72 | $2,344.23 | $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 $562.34 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $562.34 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $223.87 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $831.76 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $165.96 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $112.20 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $776.25 | $1,380.38 | $1,380.38 |
Where Iowa sits
The same service costs 5.5 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· 8th of 51
$2,455
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.