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 $6,760.83 Typical High $7,943.28 | Facility | None | $4,265.80 | $6,760.83 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $6,918.31 Typical High $6,918.31 | Professional | None | $3,715.35 | $6,918.31 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $4,365.16 Median $9,332.54 Typical High $11,481.54 | Professional | None | $4,365.16 | $9,332.54 | $11,481.54 |
Hally Health Setting Professional Modifier None Typical Low $3,890.45 Median $5,754.40 Typical High $11,748.98 | Professional | None | $3,890.45 | $5,754.40 | $11,748.98 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $5,011.87 Typical High $10,715.19 | Facility | None | $588.84 | $5,011.87 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $4,786.30 Median $9,120.11 Typical High $31,622.78 | Professional | None | $4,786.30 | $9,120.11 | $31,622.78 |
Midlands Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $11,481.54 | Professional | None | $9,332.54 | $9,332.54 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $7,244.36 Median $10,232.93 Typical High $12,022.64 | Professional | None | $7,244.36 | $10,232.93 | $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 $4,365.16 Median $5,888.44 Typical High $11,220.18 | Professional | None | $4,365.16 | $5,888.44 | $11,220.18 |
Wellmark Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $9,549.93 | Professional | None | $8,709.64 | $8,709.64 | $9,549.93 |
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 $1,862.09 Median $3,388.44 Typical High $3,388.44 | Professional | 52 · Reduced service | $1,862.09 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $741.31 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $5,128.61 Typical High $5,128.61 | Professional | 54 · Surgery only | $2,818.38 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $1,023.29 Typical High $1,023.29 | Professional | 55 · Aftercare only | $562.34 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $371.54 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $4,786.30 Typical High $4,786.30 | Professional | 78 · Unplanned return to OR | $2,630.27 | $4,786.30 | $4,786.30 |
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· 5th of 51
$8,710
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.