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 $4,265.80 Median $6,309.57 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,309.57 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,467.37 Median $6,309.57 Typical High $6,309.57 | Professional | None | $3,467.37 | $6,309.57 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $4,073.80 Median $8,511.38 Typical High $10,715.19 | Professional | None | $4,073.80 | $8,511.38 | $10,715.19 |
Hally Health Setting Professional Modifier None Typical Low $3,630.78 Median $5,623.41 Typical High $10,964.78 | Professional | None | $3,630.78 | $5,623.41 | $10,964.78 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $4,677.35 Typical High $9,772.37 | Facility | None | $588.84 | $4,677.35 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $4,466.84 Median $8,317.64 Typical High $28,840.32 | Professional | None | $4,466.84 | $8,317.64 | $28,840.32 |
Midlands Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,715.19 | Professional | None | $8,511.38 | $8,511.38 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $6,760.83 Median $9,549.93 Typical High $12,022.64 | Professional | None | $6,760.83 | $9,549.93 | $12,022.64 |
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 $3,981.07 Median $5,495.41 Typical High $10,471.29 | Professional | None | $3,981.07 | $5,495.41 | $10,471.29 |
Wellmark Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | None | $7,943.28 | $7,943.28 | $8,912.51 |
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 $1,737.80 Median $3,162.28 Typical High $3,162.28 | Professional | 52 · Reduced service | $1,737.80 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $1,258.93 Typical High $1,258.93 | Professional | 53 · Discontinued | $691.83 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $4,786.30 Typical High $4,786.30 | Professional | 54 · Surgery only | $2,630.27 | $4,786.30 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $954.99 Typical High $954.99 | Professional | 55 · Aftercare only | $524.81 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $346.74 Median $630.96 Typical High $630.96 | Professional | 56 · Pre-op care only | $346.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $4,466.84 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $2,454.71 | $4,466.84 | $4,466.84 |
Where Iowa sits
The same service costs 21.9 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· 4th of 51
$7,943
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.