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 $602.56 Median $6,760.83 Typical High $10,471.29 | Facility | None | $602.56 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $616.60 | Professional | None | $218.78 | $371.54 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,090.30 | Facility | None | $1,778.28 | $2,398.83 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $602.56 Typical High $891.25 | Professional | None | $363.08 | $602.56 | $891.25 |
Hally Health Setting Professional Modifier None Typical Low $199.53 Median $416.87 Typical High $870.96 | Professional | None | $199.53 | $416.87 | $870.96 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $1,380.38 Typical High $7,413.10 | Facility | None | $478.63 | $1,380.38 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $741.31 Typical High $2,818.38 | Professional | None | $331.13 | $741.31 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $912.01 | Professional | None | $489.78 | $645.65 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $3,090.30 | Facility | None | $1,659.59 | $2,398.83 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,047.13 | Professional | None | $549.54 | $630.96 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $239.88 Median $398.11 Typical High $812.83 | Professional | None | $239.88 | $398.11 | $812.83 |
Wellmark Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $912.01 | Professional | None | $436.52 | $501.19 | $912.01 |
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 $109.65 Median $186.21 Typical High $309.03 | Professional | 52 · Reduced service | $109.65 | $186.21 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $74.13 Typical High $123.03 | Professional | 53 · Discontinued | $44.67 | $74.13 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $275.42 Typical High $467.74 | Professional | 54 · Surgery only | $165.96 | $275.42 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $54.95 Typical High $93.33 | Professional | 55 · Aftercare only | $33.11 | $54.95 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $37.15 Typical High $61.66 | Professional | 56 · Pre-op care only | $21.88 | $37.15 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $257.04 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $154.88 | $257.04 | $436.52 |
Where Iowa sits
The same service costs 3.7 times more in Wyoming 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
$575
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.