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 $4,265.80 Median $5,888.44 Typical High $7,943.28 | Facility | None | $4,265.80 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $4,677.35 Typical High $4,677.35 | Professional | None | $2,570.40 | $4,677.35 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $6,456.54 Typical High $7,943.28 | Professional | None | $3,162.28 | $6,456.54 | $7,943.28 |
Hally Health Setting Professional Modifier None Typical Low $2,691.53 Median $4,265.80 Typical High $16,218.10 | Professional | None | $2,691.53 | $4,265.80 | $16,218.10 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $3,715.35 Typical High $7,413.10 | Facility | None | $588.84 | $3,715.35 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $3,235.94 Median $6,309.57 Typical High $20,892.96 | Professional | None | $3,235.94 | $6,309.57 | $20,892.96 |
Midlands Setting Professional Modifier None Typical Low $6,165.95 Median $6,456.54 Typical High $7,943.28 | Professional | None | $6,165.95 | $6,456.54 | $7,943.28 |
Midlands Setting Professional Modifier None Typical Low $5,128.61 Median $7,079.46 Typical High $8,912.51 | Professional | None | $5,128.61 | $7,079.46 | $8,912.51 |
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 $2,818.38 Median $3,981.07 Typical High $7,244.36 | Professional | None | $2,818.38 | $3,981.07 | $7,244.36 |
Wellmark Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,606.93 | Professional | None | $6,025.60 | $6,025.60 | $6,606.93 |
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 $1,288.25 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,288.25 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $512.86 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,905.46 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $380.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $257.04 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $1,778.28 | $3,311.31 | $3,311.31 |
Where Iowa sits
The same service costs 21.4 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
$6,026
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.