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 $630.96 Median $3,548.13 Typical High $6,760.83 | Facility | None | $630.96 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $630.96 Typical High $630.96 | Professional | None | $478.63 | $630.96 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,715.35 Typical High $4,466.84 | Facility | None | $954.99 | $3,715.35 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,148.15 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,380.38 | Professional | None | $457.09 | $691.83 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,659.59 Typical High $12,022.64 | Facility | None | $758.58 | $1,659.59 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $3,715.35 | Professional | None | $588.84 | $1,047.13 | $3,715.35 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,096.48 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $4,466.84 | Facility | None | $1,445.44 | $3,715.35 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $1,513.56 | Professional | None | $831.76 | $1,288.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $13,182.57 | Facility | None | $1,258.93 | $3,630.78 | $13,182.57 |
United Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,513.56 | Professional | None | $537.03 | $776.25 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $977.24 | Professional | None | $831.76 | $831.76 | $977.24 |
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 $239.88 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $95.50 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $354.81 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $70.79 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $331.13 | $446.68 | $446.68 |
Where Iowa sits
The same service costs 6.5 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· 6th of 51
$1,047
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.