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 $1,122.02 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,122.02 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $1,122.02 Typical High $1,122.02 | Professional | None | $676.08 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $3,388.44 | Facility | None | $1,288.25 | $2,754.23 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $1,905.46 | Professional | None | $758.58 | $1,380.38 | $1,905.46 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,445.44 | Professional | None | $575.44 | $851.14 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $9,120.11 | Facility | None | $891.25 | $2,344.23 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $4,786.30 | Professional | None | $741.31 | $1,412.54 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,380.38 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $1,659.59 Median $2,691.53 Typical High $3,388.44 | Facility | None | $1,659.59 | $2,691.53 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $676.08 Median $977.24 Typical High $1,862.09 | Professional | None | $676.08 | $977.24 | $1,862.09 |
Wellmark Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $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 $338.84 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $338.84 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $134.90 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $501.19 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $100.00 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $67.61 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $467.74 | $794.33 | $794.33 |
Where Iowa sits
The same service costs 8.5 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· 7th of 51
$1,380
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.