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 $3,715.35 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,715.35 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,041.74 | $3,715.35 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $5,128.61 Typical High $6,309.57 | Professional | None | $2,398.83 | $5,128.61 | $6,309.57 |
Hally Health Setting Professional Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $7,079.46 | Professional | None | $2,137.96 | $3,311.31 | $7,079.46 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $3,467.37 Typical High $6,456.54 | Facility | None | $588.84 | $3,467.37 | $6,456.54 |
Medica Setting Professional Modifier None Typical Low $2,691.53 Median $5,011.87 Typical High $16,595.87 | Professional | None | $2,691.53 | $5,011.87 | $16,595.87 |
Midlands Setting Professional Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $6,309.57 | Professional | None | $5,011.87 | $5,128.61 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $3,981.07 Median $5,623.41 Typical High $7,079.46 | Professional | None | $3,981.07 | $5,623.41 | $7,079.46 |
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 $2,398.83 Median $3,235.94 Typical High $6,165.95 | Professional | None | $2,398.83 | $3,235.94 | $6,165.95 |
Wellmark Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,248.07 | Professional | None | $4,677.35 | $4,677.35 | $5,248.07 |
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 $1,023.29 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,023.29 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $407.38 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,548.82 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $309.03 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $204.17 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,445.44 | $2,630.27 | $2,630.27 |
Where Iowa sits
The same service costs 22.4 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· 6th of 51
$4,677
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.