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 $1,047.13 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,047.13 | $2,238.72 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $3,162.28 | Professional | None | $912.01 | $1,348.96 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $4,897.79 | Facility | None | $588.84 | $1,862.09 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,187.76 Typical High $7,244.36 | Professional | None | $1,122.02 | $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 $1,905.46 Median $2,454.71 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,454.71 | $2,884.03 |
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 $1,412.54 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,412.54 | $2,691.53 |
Wellmark Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Professional | None | $2,187.76 | $2,187.76 | $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 $186.21 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $186.21 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $691.83 | $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 $645.65 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $645.65 | $1,148.15 | $1,148.15 |
Where Iowa sits
The same service costs 4.9 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
$2,188
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.