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 $4,466.84 Median $9,549.93 Typical High $11,748.98 | Professional | None | $4,466.84 | $9,549.93 | $11,748.98 |
Hally Health Setting Professional Modifier None Typical Low $3,981.07 Median $6,165.95 Typical High $15,135.61 | Professional | None | $3,981.07 | $6,165.95 | $15,135.61 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $5,011.87 Typical High $11,481.54 | Facility | None | $588.84 | $5,011.87 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $4,786.30 Median $9,120.11 Typical High $30,902.95 | Professional | None | $4,786.30 | $9,120.11 | $30,902.95 |
Midlands Setting Professional Modifier None Typical Low $9,549.93 Median $9,549.93 Typical High $11,748.98 | Professional | None | $9,549.93 | $9,549.93 | $11,748.98 |
Midlands Setting Professional Modifier None Typical Low $7,413.10 Median $10,471.29 Typical High $13,182.57 | Professional | None | $7,413.10 | $10,471.29 | $13,182.57 |
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 $6,025.60 Typical High $11,481.54 | Professional | None | $4,365.16 | $6,025.60 | $11,481.54 |
Wellmark Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $9,772.37 | Professional | None | $8,709.64 | $8,709.64 | $9,772.37 |
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 $1,905.46 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $1,905.46 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $1,380.38 Typical High $1,380.38 | Professional | 53 · Discontinued | $758.58 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,884.03 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $575.44 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $380.19 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $2,691.53 | $4,897.79 | $4,897.79 |
Where Iowa sits
The same service costs 20.9 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
$9,120
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.