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 $602.56 Median $4,168.69 Typical High $7,244.36 | Facility | None | $602.56 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $812.83 | Professional | None | $436.52 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,737.80 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $812.83 Typical High $1,148.15 | Professional | None | $398.11 | $812.83 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $812.83 | Professional | None | $281.84 | $562.34 | $812.83 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,288.25 Typical High $6,025.60 | Facility | None | $630.96 | $1,288.25 | $6,025.60 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $954.99 Typical High $3,548.13 | Professional | None | $537.03 | $954.99 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,202.26 | Professional | None | $602.56 | $851.14 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
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 $338.84 Median $616.60 Typical High $1,122.02 | Professional | None | $338.84 | $616.60 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,174.90 | Professional | None | $575.44 | $676.08 | $1,174.90 |
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 $213.80 Median $275.42 Typical High $407.38 | Professional | 52 · Reduced service | $213.80 | $275.42 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $109.65 Typical High $162.18 | Professional | 53 · Discontinued | $87.10 | $109.65 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $407.38 Typical High $616.60 | Professional | 54 · Surgery only | $323.59 | $407.38 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $83.18 Typical High $123.03 | Professional | 55 · Aftercare only | $64.57 | $83.18 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $54.95 Typical High $81.28 | Professional | 56 · Pre-op care only | $43.65 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $380.19 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $302.00 | $380.19 | $575.44 |
Where Iowa sits
The same service costs 5.9 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
$871
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.