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 $2,344.23 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,344.23 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,288.25 | $2,344.23 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $3,235.94 Typical High $3,981.07 | Professional | None | $1,548.82 | $3,235.94 | $3,981.07 |
Hally Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,995.26 Typical High $4,570.88 | Professional | None | $1,348.96 | $1,995.26 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,630.27 Typical High $4,897.79 | Facility | None | $588.84 | $2,630.27 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $10,471.29 | Professional | None | $1,698.24 | $3,162.28 | $10,471.29 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,981.07 | Professional | None | $3,235.94 | $3,235.94 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $4,265.80 | Professional | None | $2,691.53 | $3,548.13 | $4,265.80 |
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 $1,513.56 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,513.56 | $2,041.74 | $3,890.45 |
Wellmark Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,467.37 | Professional | None | $3,090.30 | $3,090.30 | $3,467.37 |
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 $660.69 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $660.69 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $263.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $977.24 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $199.53 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $131.83 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $912.01 | $1,659.59 | $1,659.59 |
Where Iowa sits
The same service costs 5.0 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· 6th of 51
$3,090
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.