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 $891.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $891.25 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $3,388.44 | Facility | None | $954.99 | $2,754.23 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,819.70 Typical High $2,511.89 | Professional | None | $870.96 | $1,819.70 | $2,511.89 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,698.24 | Professional | None | $758.58 | $1,047.13 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,344.23 Typical High $9,120.11 | Facility | None | $933.25 | $2,344.23 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,778.28 Typical High $6,456.54 | Professional | None | $912.01 | $1,778.28 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,819.70 | $1,819.70 | $2,398.83 |
Midlands Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,659.59 | $2,691.53 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,471.29 | Facility | None | $1,380.38 | $4,365.16 | $10,471.29 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $2,290.87 | Professional | None | $831.76 | $1,202.26 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
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 $446.68 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $446.68 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $177.83 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $676.08 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $134.90 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $89.13 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $630.96 | $1,047.13 | $1,047.13 |
Where Iowa sits
The same service costs 8.3 times more in Wyoming 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
$1,820
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.