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 $891.25 Median $5,888.44 Typical High $7,943.28 | Facility | None | $891.25 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $891.25 | Professional | None | $575.44 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,754.23 | Facility | None | $1,479.11 | $2,041.74 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,348.96 | $1,737.80 |
Hally Health Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,548.82 | Professional | None | $588.84 | $912.01 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,737.80 Typical High $6,606.93 | Facility | None | $794.33 | $1,737.80 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,318.26 Typical High $4,677.35 | Professional | None | $707.95 | $1,318.26 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,348.96 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $2,884.03 | Facility | None | $1,230.27 | $2,290.87 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,479.11 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,073.80 Typical High $7,943.28 | Facility | None | $1,380.38 | $4,073.80 | $7,943.28 |
United Setting Professional Modifier None Typical Low $630.96 Median $933.25 Typical High $1,698.24 | Professional | None | $630.96 | $933.25 | $1,698.24 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
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 $288.40 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $288.40 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $114.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $436.52 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $87.10 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $57.54 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $407.38 | $616.60 | $616.60 |
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· 7th of 51
$1,288
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.