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 $1,737.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,737.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $2,089.30 Typical High $2,454.71 | Facility | None | $218.78 | $2,089.30 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,096.48 | $2,137.96 | $2,884.03 |
Hally Health Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,187.76 | Professional | None | $891.25 | $1,288.25 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $6,918.31 | Facility | None | $1,202.26 | $2,454.71 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,137.96 Typical High $7,413.10 | Professional | None | $1,122.02 | $2,137.96 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,137.96 | $2,137.96 | $2,691.53 |
Midlands Setting Facility Modifier None Typical Low $234.42 Median $2,041.74 Typical High $2,454.71 | Facility | None | $234.42 | $2,041.74 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,258.93 | $3,467.37 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,479.11 | $2,818.38 |
Wellmark Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
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 $512.86 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $512.86 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $204.17 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $758.58 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $154.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $102.33 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $707.95 | $1,202.26 | $1,202.26 |
Where Iowa sits
The same service costs 7.2 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· 5th of 51
$2,089
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.