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 $2,691.53 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,691.53 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,479.11 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $3,715.35 Typical High $4,570.88 | Professional | None | $1,737.80 | $3,715.35 | $4,570.88 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $5,128.61 | Professional | None | $1,513.56 | $2,290.87 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,951.21 Typical High $4,897.79 | Facility | None | $588.84 | $2,951.21 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $3,630.78 Typical High $12,022.64 | Professional | None | $1,862.09 | $3,630.78 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,715.35 | $3,715.35 | $4,570.88 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $4,897.79 | Professional | None | $2,951.21 | $4,073.80 | $4,897.79 |
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 $1,698.24 Median $2,344.23 Typical High $4,466.84 | Professional | None | $1,698.24 | $2,344.23 | $4,466.84 |
Wellmark Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,890.45 | Professional | None | $3,467.37 | $3,467.37 | $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 $741.31 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $741.31 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $295.12 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,122.02 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $223.87 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $147.91 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,905.46 | $1,905.46 |
Where Iowa sits
The same service costs 20.4 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
$3,467
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.