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 $1,479.11 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,479.11 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,479.11 | Professional | None | $954.99 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $1,862.09 | Facility | None | $954.99 | $1,548.82 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,238.72 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $2,089.30 | Professional | None | $1,000.00 | $1,288.25 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $6,309.57 | Facility | None | $1,380.38 | $2,344.23 | $6,309.57 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $7,762.47 | Professional | None | $1,096.48 | $2,089.30 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,238.72 | $2,630.27 |
Midlands Setting Facility Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,548.82 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,019.95 | Professional | None | $1,778.28 | $2,454.71 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,513.56 | $2,818.38 |
Wellmark Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,570.40 | Professional | None | $2,187.76 | $2,187.76 | $2,570.40 |
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 $478.63 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $478.63 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $724.44 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $144.54 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $95.50 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $676.08 | $1,047.13 | $1,047.13 |
Where Iowa sits
The same service costs 5.9 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· 6th of 51
$2,138
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.