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 $1,122.02 Median $4,897.79 Typical High $7,244.36 | Facility | None | $1,122.02 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $1,445.44 | Professional | None | $691.83 | $1,122.02 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $5,888.44 | Facility | None | $1,288.25 | $4,897.79 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $2,041.74 | Professional | None | $831.76 | $1,659.59 | $2,041.74 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $1,174.90 Typical High $2,754.23 | Professional | None | $616.60 | $1,174.90 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,238.72 Typical High $12,302.69 | Facility | None | $1,071.52 | $2,238.72 | $12,302.69 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $6,456.54 | Professional | None | $1,000.00 | $1,862.09 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,862.09 | $2,137.96 |
Midlands Setting Facility Modifier None Typical Low $1,778.28 Median $4,786.30 Typical High $5,888.44 | Facility | None | $1,778.28 | $4,786.30 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,398.83 | Professional | None | $1,621.81 | $1,862.09 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $15,488.17 | Facility | None | $1,258.93 | $3,630.78 | $15,488.17 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $2,089.30 | Professional | None | $758.58 | $1,122.02 | $2,089.30 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,445.44 | $2,089.30 |
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 $346.74 Median $562.34 Typical High $724.44 | Professional | 52 · Reduced service | $346.74 | $562.34 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $138.04 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $851.14 Typical High $1,071.52 | Professional | 54 · Surgery only | $512.86 | $851.14 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $169.82 Typical High $213.80 | Professional | 55 · Aftercare only | $102.33 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $69.18 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $794.33 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $478.63 | $794.33 | $1,000.00 |
Where Iowa sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$1,514
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.