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 $933.25 Median $3,548.13 Typical High $6,760.83 | Facility | None | $933.25 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $933.25 | Professional | None | $512.86 | $933.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,290.87 Typical High $2,818.38 | Facility | None | $954.99 | $2,290.87 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,288.25 Typical High $1,584.89 | Professional | None | $588.84 | $1,288.25 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $724.44 Typical High $1,737.80 | Professional | None | $524.81 | $724.44 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,659.59 Typical High $7,244.36 | Facility | None | $776.25 | $1,659.59 | $7,244.36 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,258.93 Typical High $4,168.69 | Professional | None | $630.96 | $1,258.93 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,288.25 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,412.54 Median $2,290.87 Typical High $2,818.38 | Facility | None | $1,412.54 | $2,290.87 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,412.54 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,585.78 | Facility | None | $1,258.93 | $3,630.78 | $7,585.78 |
United Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,479.11 | Professional | None | $562.34 | $794.33 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,258.93 | $1,412.54 |
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 $257.04 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $257.04 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $102.33 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $380.19 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $77.62 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $51.29 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $354.81 | $660.69 | $660.69 |
Where Iowa sits
The same service costs 5.5 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
$1,259
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.