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 $1,096.48 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,096.48 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $1,096.48 | Professional | None | $645.65 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,137.96 | Facility | None | $1,047.13 | $1,778.28 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,348.96 Typical High $1,819.70 | Professional | None | $724.44 | $1,348.96 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,096.48 | Professional | None | $562.34 | $660.69 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,659.59 Typical High $5,754.40 | Facility | None | $645.65 | $1,659.59 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,513.56 Typical High $5,495.41 | Professional | None | $724.44 | $1,513.56 | $5,495.41 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,348.96 | $1,698.24 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,202.26 | $1,778.28 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $6,309.57 | Facility | None | $501.19 | $1,949.84 | $6,309.57 |
United Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,778.28 | Professional | None | $645.65 | $954.99 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
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 $323.59 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $323.59 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $128.82 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $489.78 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $97.72 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $64.57 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $457.09 | $776.25 | $776.25 |
Where Iowa sits
The same service costs 7.6 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
$1,349
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.