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 $1,023.29 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,023.29 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $1,023.29 Typical High $1,023.29 | Professional | None | $575.44 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,454.71 Typical High $3,388.44 | Facility | None | $1,288.25 | $2,454.71 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,348.96 Typical High $1,698.24 | Professional | None | $645.65 | $1,348.96 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $2,041.74 | Professional | None | $549.54 | $1,000.00 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,187.76 Typical High $8,709.64 | Facility | None | $954.99 | $2,187.76 | $8,709.64 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $5,888.44 | Professional | None | $741.31 | $1,348.96 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,348.96 | $1,698.24 |
Midlands Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $3,467.37 | Facility | None | $1,318.26 | $2,454.71 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,548.82 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,011.87 | $10,715.19 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,698.24 | Professional | None | $645.65 | $912.01 | $1,698.24 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
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 $288.40 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $288.40 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $114.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $87.10 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $57.54 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $407.38 | $707.95 | $707.95 |
Where Iowa sits
The same service costs 6.5 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· 6th of 51
$1,318
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.