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 $2,344.23 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,344.23 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,380.38 | $2,344.23 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,890.45 | Professional | None | $3,090.30 | $3,090.30 | $3,890.45 |
Hally Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,737.80 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,698.24 Median $3,630.78 Typical High $13,182.57 | Facility | None | $1,698.24 | $3,630.78 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,884.03 Typical High $9,772.37 | Professional | None | $1,513.56 | $2,884.03 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,818.38 | $2,818.38 | $3,548.13 |
Midlands Setting Facility Modifier None Typical Low $2,630.27 Median $5,888.44 Typical High $8,128.31 | Facility | None | $2,630.27 | $5,888.44 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $5,128.61 Typical High $14,454.40 | Facility | None | $1,778.28 | $5,128.61 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,412.54 | $2,041.74 | $3,801.89 |
Wellmark Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
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 $691.83 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $691.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $275.42 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,023.29 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $204.17 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $138.04 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $954.99 | $1,621.81 | $1,621.81 |
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· 6th of 51
$2,818
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.