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 $1,000.00 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,000.00 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,000.00 | Professional | None | $602.56 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,137.96 | Facility | None | $1,174.90 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,258.93 Typical High $1,698.24 | Professional | None | $630.96 | $1,258.93 | $1,698.24 |
Hally Health Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $1,230.27 | Professional | None | $512.86 | $741.31 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $6,165.95 | Facility | None | $831.76 | $1,621.81 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,230.27 Typical High $4,265.80 | Professional | None | $645.65 | $1,230.27 | $4,265.80 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,258.93 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,202.26 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,548.13 Typical High $7,413.10 | Facility | None | $1,258.93 | $3,548.13 | $7,413.10 |
United Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,621.81 | Professional | None | $588.84 | $851.14 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
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 $295.12 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $295.12 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $120.23 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $446.68 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $89.13 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $60.26 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $416.87 | $707.95 | $707.95 |
Where Iowa sits
The same service costs 8.5 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· 6th of 51
$1,230
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.