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 $2,754.23 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,754.23 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,754.23 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $3,890.45 Typical High $4,677.35 | Professional | None | $1,778.28 | $3,890.45 | $4,677.35 |
Hally Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $6,918.31 | Professional | None | $1,584.89 | $2,511.89 | $6,918.31 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $3,019.95 Typical High $4,897.79 | Facility | None | $588.84 | $3,019.95 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $3,715.35 Typical High $12,302.69 | Professional | None | $1,995.26 | $3,715.35 | $12,302.69 |
Midlands Setting Professional Modifier None Typical Low $3,801.89 Median $3,890.45 Typical High $4,677.35 | Professional | None | $3,801.89 | $3,890.45 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $3,019.95 Median $4,168.69 Typical High $5,370.32 | Professional | None | $3,019.95 | $4,168.69 | $5,370.32 |
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 $1,778.28 Median $2,398.83 Typical High $4,570.88 | Professional | None | $1,778.28 | $2,398.83 | $4,570.88 |
Wellmark Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,890.45 | Professional | None | $3,548.13 | $3,548.13 | $3,890.45 |
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 $758.58 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $758.58 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $302.00 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,148.15 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $229.09 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $151.36 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,949.84 | $1,949.84 |
Where Iowa sits
The same service costs 5.4 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· 4th of 51
$3,548
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.