How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,445 to $9,772Professionalmedian $3,981 · 10th to 90th $2,042 to $5,248
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 $2,818.38 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,818.38 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,659.59 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,819.70 | Facility | None | $1,318.26 | $1,659.59 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $5,128.61 | Professional | None | $3,467.37 | $4,073.80 | $5,128.61 |
Hally Health Setting Professional Modifier None Typical Low $1,659.59 Median $2,754.23 Typical High $3,981.07 | Professional | None | $1,659.59 | $2,754.23 | $3,981.07 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,786.30 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $4,265.80 Typical High $18,197.01 | Professional | None | $2,041.74 | $4,265.80 | $18,197.01 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $4,897.79 | Professional | None | $3,467.37 | $4,073.80 | $4,897.79 |
Midlands Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,819.70 | Facility | None | $1,318.26 | $1,659.59 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $3,630.78 Median $3,981.07 Typical High $8,709.64 | Professional | None | $3,630.78 | $3,981.07 | $8,709.64 |
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 $1,819.70 Median $2,754.23 Typical High $5,011.87 | Professional | None | $1,819.70 | $2,754.23 | $5,011.87 |
Wellmark Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,073.80 | Professional | None | $3,467.37 | $3,467.37 | $4,073.80 |
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 $812.83 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $812.83 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $331.13 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,230.27 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $245.47 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $165.96 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,995.26 | $1,995.26 |
Where Iowa sits
The same service costs 18.6 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
$3,981
AK $7,413TX $398
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.