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 $1,621.81 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,621.81 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $891.25 | $1,621.81 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,202.26 | $2,238.72 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,621.81 Typical High $3,235.94 | Professional | None | $933.25 | $1,621.81 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $4,897.79 | Facility | None | $588.84 | $2,137.96 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,187.76 Typical High $7,244.36 | Professional | None | $1,202.26 | $2,187.76 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,238.72 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,454.71 | $3,090.30 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,445.44 | $2,691.53 |
Wellmark Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,398.83 | Professional | None | $2,137.96 | $2,137.96 | $2,398.83 |
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 $457.09 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $457.09 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $181.97 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $676.08 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $138.04 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $91.20 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $630.96 | $1,148.15 | $1,148.15 |
Where Iowa sits
The same service costs 24.5 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
$2,138
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.