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 $758.58 Median $2,951.21 Typical High $6,760.83 | Facility | None | $758.58 | $2,951.21 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $758.58 Typical High $758.58 | Professional | None | $416.87 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,238.72 Typical High $2,884.03 | Facility | None | $645.65 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $1,023.29 Typical High $1,258.93 | Professional | None | $446.68 | $1,023.29 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $398.11 Median $691.83 Typical High $1,445.44 | Professional | None | $398.11 | $691.83 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $7,943.28 | Facility | None | $630.96 | $1,288.25 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,000.00 Typical High $3,388.44 | Professional | None | $501.19 | $1,000.00 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,023.29 | $1,258.93 |
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 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,412.54 | Professional | None | $812.83 | $1,148.15 | $1,412.54 |
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 $457.09 Median $630.96 Typical High $1,202.26 | Professional | None | $457.09 | $630.96 | $1,202.26 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | None | $954.99 | $954.99 | $1,047.13 |
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 $208.93 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $208.93 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $83.18 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $316.23 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $63.10 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $41.69 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $295.12 | $524.81 | $524.81 |
Where Iowa sits
The same service costs 6.2 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· 6th of 51
$1,000
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.