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 $5,011.87 Typical High $7,244.36 | Facility | None | $602.56 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $416.87 | Professional | None | $229.09 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $2,884.03 | Facility | None | $1,288.25 | $2,238.72 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $562.34 Typical High $676.08 | Professional | None | $288.40 | $562.34 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $229.09 Median $389.05 Typical High $794.33 | Professional | None | $229.09 | $389.05 | $794.33 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $1,659.59 Typical High $7,943.28 | Facility | None | $416.87 | $1,659.59 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $549.54 Typical High $1,862.09 | Professional | None | $288.40 | $549.54 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $676.08 | Professional | None | $549.54 | $562.34 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $1,318.26 Median $2,238.72 Typical High $2,884.03 | Facility | None | $1,318.26 | $2,238.72 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $630.96 Typical High $758.58 | Professional | None | $457.09 | $630.96 | $758.58 |
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 $251.19 Median $354.81 Typical High $660.69 | Professional | None | $251.19 | $354.81 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | None | $489.78 | $489.78 | $549.54 |
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 $117.49 Median $208.93 Typical High $208.93 | Professional | 52 · Reduced service | $117.49 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $83.18 Typical High $83.18 | Professional | 53 · Discontinued | $46.77 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $316.23 Typical High $316.23 | Professional | 54 · Surgery only | $177.83 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $63.10 Typical High $63.10 | Professional | 55 · Aftercare only | $35.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $41.69 Typical High $41.69 | Professional | 56 · Pre-op care only | $23.44 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $295.12 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $165.96 | $295.12 | $295.12 |
Where Iowa sits
The same service costs 6.0 times more in Alaska than in Utah. 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
$550
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.