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 $2,137.96 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,137.96 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,148.15 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $3,548.13 | Professional | None | $1,380.38 | $2,951.21 | $3,548.13 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $4,168.69 | Professional | None | $1,202.26 | $1,862.09 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,454.71 Typical High $4,897.79 | Facility | None | $588.84 | $2,454.71 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,884.03 Typical High $9,332.54 | Professional | None | $1,513.56 | $2,884.03 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $2,884.03 Median $2,951.21 Typical High $3,630.78 | Professional | None | $2,884.03 | $2,951.21 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $3,981.07 | Professional | None | $2,290.87 | $3,235.94 | $3,981.07 |
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 $1,348.96 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,348.96 | $1,862.09 | $3,548.13 |
Wellmark Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,691.53 | $2,691.53 | $3,019.95 |
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 $588.84 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $588.84 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $234.42 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $870.96 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $173.78 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $117.49 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $812.83 | $1,479.11 | $1,479.11 |
Where Iowa sits
The same service costs 5.4 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· 4th of 51
$2,818
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.