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 $933.25 Median $5,888.44 Typical High $7,943.28 | Facility | None | $933.25 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $933.25 | Professional | None | $512.86 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,380.38 | Facility | None | $1,023.29 | $1,258.93 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,202.26 Typical High $1,548.82 | Professional | None | $630.96 | $1,202.26 | $1,548.82 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $1,621.81 | Professional | None | $524.81 | $891.25 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,513.56 Typical High $4,677.35 | Facility | None | $724.44 | $1,513.56 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,174.90 Typical High $4,168.69 | Professional | None | $645.65 | $1,174.90 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,202.26 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,380.38 | Facility | None | $1,023.29 | $1,258.93 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,412.54 | $1,778.28 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,479.11 | Professional | None | $575.44 | $794.33 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | None | $1,230.27 | $1,230.27 | $1,348.96 |
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 $251.19 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $251.19 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $102.33 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $380.19 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $75.86 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $51.29 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $354.81 | $645.65 | $645.65 |
Where Iowa sits
The same service costs 5.5 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· 5th of 51
$1,202
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.