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 $660.69 Median $3,548.13 Typical High $6,760.83 | Facility | None | $660.69 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | None | $436.52 | $660.69 | $660.69 |
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 $933.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $933.25 | $1,047.13 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $1,174.90 | Professional | None | $416.87 | $691.83 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $1,584.89 Typical High $5,888.44 | Facility | None | $812.83 | $1,584.89 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $4,897.79 | Professional | None | $537.03 | $1,000.00 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $891.25 | $1,047.13 | $1,258.93 |
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 $891.25 Median $1,047.13 Typical High $1,513.56 | Professional | None | $891.25 | $1,047.13 | $1,513.56 |
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 $467.74 Median $724.44 Typical High $1,318.26 | Professional | None | $467.74 | $724.44 | $1,318.26 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | None | $851.14 | $851.14 | $1,023.29 |
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 $218.78 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $87.10 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $331.13 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $66.07 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $43.65 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $309.03 | $467.74 | $467.74 |
Where Iowa sits
The same service costs 5.8 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· 6th of 51
$1,023
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.