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 $5,888.44 Typical High $7,943.28 | Facility | None | $4,265.80 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $5,754.40 | Professional | None | $3,162.28 | $5,754.40 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $6,309.57 Median $7,762.47 Typical High $9,772.37 | Professional | None | $6,309.57 | $7,762.47 | $9,772.37 |
Hally Health Setting Professional Modifier None Typical Low $3,311.31 Median $5,128.61 Typical High $12,882.50 | Professional | None | $3,311.31 | $5,128.61 | $12,882.50 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $4,073.80 Typical High $9,120.11 | Facility | None | $588.84 | $4,073.80 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $3,981.07 Median $7,762.47 Typical High $25,703.96 | Professional | None | $3,981.07 | $7,762.47 | $25,703.96 |
Midlands Setting Professional Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $9,772.37 | Professional | None | $7,943.28 | $8,128.31 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $6,309.57 Median $8,709.64 Typical High $10,715.19 | Professional | None | $6,309.57 | $8,709.64 | $10,715.19 |
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 $3,715.35 Median $5,011.87 Typical High $9,549.93 | Professional | None | $3,715.35 | $5,011.87 | $9,549.93 |
Wellmark Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $8,128.31 | Professional | None | $7,413.10 | $7,413.10 | $8,128.31 |
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 $1,584.89 Median $2,884.03 Typical High $2,884.03 | Professional | 52 · Reduced service | $1,584.89 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $1,174.90 Typical High $1,174.90 | Professional | 53 · Discontinued | $630.96 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $4,365.16 Typical High $4,365.16 | Professional | 54 · Surgery only | $2,398.83 | $4,365.16 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $870.96 Typical High $870.96 | Professional | 55 · Aftercare only | $478.63 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $575.44 Typical High $575.44 | Professional | 56 · Pre-op care only | $316.23 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $4,073.80 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $2,238.72 | $4,073.80 | $4,073.80 |
Where Iowa sits
The same service costs 27.5 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
$7,413
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.