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 $2,511.89 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,511.89 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,348.96 | $2,511.89 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $3,388.44 Typical High $4,265.80 | Professional | None | $1,584.89 | $3,388.44 | $4,265.80 |
Hally Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $4,365.16 | Professional | None | $1,412.54 | $2,041.74 | $4,365.16 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,754.23 Typical High $4,897.79 | Facility | None | $588.84 | $2,754.23 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $3,235.94 Typical High $11,220.18 | Professional | None | $1,737.80 | $3,235.94 | $11,220.18 |
Midlands Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,265.80 | Professional | None | $3,388.44 | $3,388.44 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $3,801.89 Typical High $4,365.16 | Professional | None | $2,754.23 | $3,801.89 | $4,365.16 |
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 $1,584.89 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,584.89 | $2,187.76 | $4,073.80 |
Wellmark Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,630.78 | Professional | None | $3,235.94 | $3,235.94 | $3,630.78 |
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 $676.08 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $676.08 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $269.15 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,023.29 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $204.17 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $134.90 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $954.99 | $1,737.80 | $1,737.80 |
Where Iowa sits
The same service costs 5.1 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
$3,236
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.