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 $1,230.27 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,230.27 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,230.27 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,737.80 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,659.59 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,137.96 Typical High $5,888.44 | Facility | None | $602.56 | $2,137.96 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $2,137.96 Typical High $7,762.47 | Professional | None | $1,318.26 | $2,137.96 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,737.80 | $1,737.80 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,089.30 | $2,754.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $6,918.31 | Facility | None | $588.84 | $2,344.23 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,202.26 | $1,737.80 | $3,162.28 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,348.96 | $1,584.89 |
4 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 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $812.83 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $190.55 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $123.03 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $891.25 |
Where Iowa sits
The same service costs 16.2 times more in Alaska than in Texas. 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· 12th of 51
$1,738
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.