How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,778 to $9,772Professionalmedian $4,571 · 10th to 90th $2,344 to $6,026
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 $3,162.28 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,162.28 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,862.09 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,659.59 | $2,089.30 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $4,570.88 Typical High $5,754.40 | Professional | None | $3,981.07 | $4,570.88 | $5,754.40 |
Hally Health Setting Professional Modifier None Typical Low $1,905.46 Median $3,090.30 Typical High $4,365.16 | Professional | None | $1,905.46 | $3,090.30 | $4,365.16 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $5,128.61 Typical High $9,772.37 | Facility | None | $1,380.38 | $5,128.61 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $4,897.79 Typical High $18,197.01 | Professional | None | $2,344.23 | $4,897.79 | $18,197.01 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,890.45 | $4,570.88 | $5,623.41 |
Midlands Setting Facility Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,344.23 | Facility | None | $1,659.59 | $2,089.30 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $4,365.16 Typical High $9,549.93 | Professional | None | $3,890.45 | $4,365.16 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $4,786.30 Typical High $10,471.29 | Facility | None | $1,819.70 | $4,786.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,090.30 Typical High $5,754.40 | Professional | None | $2,041.74 | $3,090.30 | $5,754.40 |
Wellmark Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,801.89 | $3,801.89 | $4,570.88 |
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 $933.25 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $933.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $371.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,380.38 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $275.42 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $186.21 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,238.72 | $2,238.72 |
Where Iowa sits
The same service costs 19.5 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· 4th of 51
$4,571
AK $8,318TX $427
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.