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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,230.27 Typical High $1,949.84 | Professional | None | $398.11 | $1,230.27 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $3,019.95 | Facility | None | $1,778.28 | $2,290.87 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $3,981.07 | Professional | None | $870.96 | $1,202.26 | $3,981.07 |
Hally Health Setting Professional Modifier None Typical Low $354.81 Median $1,737.80 Typical High $6,025.60 | Professional | None | $354.81 | $1,737.80 | $6,025.60 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $8,511.38 | Facility | None | $954.99 | $3,715.35 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $3,715.35 Typical High $12,882.50 | Professional | None | $1,000.00 | $3,715.35 | $12,882.50 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $2,951.21 Typical High $3,801.89 | Professional | None | $870.96 | $2,951.21 | $3,801.89 |
Midlands Setting Facility Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $3,162.28 | Facility | None | $1,778.28 | $2,290.87 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $4,466.84 | Professional | None | $1,000.00 | $1,174.90 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,584.89 | $5,011.87 | $11,220.18 |
United Setting Professional Modifier None Typical Low $489.78 Median $1,584.89 Typical High $4,677.35 | Professional | None | $489.78 | $1,584.89 | $4,677.35 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $3,311.31 | Professional | None | $707.95 | $831.76 | $3,311.31 |
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 $199.53 Median $426.58 Typical High $954.99 | Professional | 52 · Reduced service | $199.53 | $426.58 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $169.82 Typical High $389.05 | Professional | 53 · Discontinued | $79.43 | $169.82 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $645.65 Typical High $1,445.44 | Professional | 54 · Surgery only | $302.00 | $645.65 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $128.82 Typical High $288.40 | Professional | 55 · Aftercare only | $60.26 | $128.82 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $85.11 Typical High $194.98 | Professional | 56 · Pre-op care only | $39.81 | $85.11 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $602.56 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $281.84 | $602.56 | $1,348.96 |
Where Iowa sits
The same service costs 4.9 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· 3rd 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.