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 $5,370.32 Typical High $7,943.28 | Facility | None | $891.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $891.25 Typical High $891.25 | Professional | None | $524.81 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,380.38 | $2,754.23 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $1,071.52 Typical High $1,479.11 | Professional | None | $575.44 | $1,071.52 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $660.69 Typical High $1,174.90 | Professional | None | $457.09 | $660.69 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $9,120.11 | Facility | None | $831.76 | $2,344.23 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,122.02 Typical High $6,918.31 | Professional | None | $616.60 | $1,122.02 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,071.52 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $1,380.38 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,380.38 | $2,691.53 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $537.03 Median $776.25 Typical High $1,445.44 | Professional | None | $537.03 | $776.25 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | None | $891.25 | $891.25 | $1,047.13 |
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 $263.03 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $263.03 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $104.71 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $389.05 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $79.43 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $52.48 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $363.08 | $616.60 | $616.60 |
Where Iowa sits
The same service costs 7.9 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
$1,122
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.