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 $549.54 Median $5,248.07 Typical High $7,943.28 | Facility | None | $549.54 | $5,248.07 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $831.76 | Professional | None | $346.74 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,380.38 | $2,691.53 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,174.90 | Professional | None | $794.33 | $933.25 | $1,174.90 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $1,023.29 | Professional | None | $346.74 | $602.56 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,413.10 | Facility | None | $645.65 | $1,380.38 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $912.01 Typical High $2,691.53 | Professional | None | $562.34 | $912.01 | $2,691.53 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,174.90 | Professional | None | $870.96 | $933.25 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $3,388.44 | Facility | None | $1,445.44 | $2,630.27 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $1,348.96 | Professional | None | $707.95 | $1,000.00 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $398.11 Median $602.56 Typical High $1,148.15 | Professional | None | $398.11 | $602.56 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
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 $177.83 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $177.83 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $70.79 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $269.15 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $53.70 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $35.48 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $446.68 |
Where Iowa sits
The same service costs 3.8 times more in Alaska than in Utah. 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· 5th of 51
$871
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.