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 $1,905.46 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,905.46 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,905.46 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $2,630.27 Typical High $3,235.94 | Professional | None | $1,230.27 | $2,630.27 | $3,235.94 |
Hally Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $3,630.78 | Professional | None | $1,071.52 | $1,513.56 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,995.26 Typical High $4,677.35 | Facility | None | $724.44 | $1,995.26 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $2,570.40 Typical High $8,511.38 | Professional | None | $1,318.26 | $2,570.40 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,235.94 | Professional | None | $2,630.27 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,884.03 Typical High $3,235.94 | Professional | None | $2,089.30 | $2,884.03 | $3,235.94 |
United Setting Facility Modifier None Typical Low $724.44 Median $1,778.28 Typical High $5,495.41 | Facility | None | $724.44 | $1,778.28 | $5,495.41 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,659.59 | $3,090.30 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,691.53 | Professional | None | $2,454.71 | $2,454.71 | $2,691.53 |
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 $524.81 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $524.81 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $208.93 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $794.33 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $158.49 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $104.71 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $741.31 | $1,318.26 | $1,318.26 |
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
$2,455
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.