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 $776.25 Median $4,897.79 Typical High $7,244.36 | Facility | None | $776.25 | $4,897.79 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $954.99 | Professional | None | $512.86 | $776.25 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,137.96 | Facility | None | $1,288.25 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,148.15 Typical High $1,479.11 | Professional | None | $512.86 | $1,148.15 | $1,479.11 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $707.95 Typical High $977.24 | Professional | None | $389.05 | $707.95 | $977.24 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,479.11 Typical High $6,025.60 | Facility | None | $891.25 | $1,479.11 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $4,677.35 | Professional | None | $741.31 | $1,174.90 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,380.38 | Professional | None | $977.24 | $1,174.90 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,288.25 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $501.19 Median $831.76 Typical High $1,445.44 | Professional | None | $501.19 | $831.76 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,348.96 | Professional | None | $794.33 | $933.25 | $1,348.96 |
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 $380.19 Typical High $478.63 | Professional | 52 · Reduced service | $263.03 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $104.71 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $389.05 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $114.82 Typical High $144.54 | Professional | 55 · Aftercare only | $77.62 | $114.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $77.62 Typical High $95.50 | Professional | 56 · Pre-op care only | $52.48 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $363.08 | $537.03 | $660.69 |
Where Iowa sits
The same service costs 6.5 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· 4th of 51
$1,148
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.