How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,660 to $11,749Professionalmedian $3,162 · 10th to 90th $1,905 to $5,012
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 $2,691.53 Median $5,011.87 Typical High $7,244.36 | Facility | None | $2,691.53 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,584.89 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,754.40 | $7,244.36 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,715.35 Typical High $4,677.35 | Professional | None | $3,388.44 | $3,715.35 | $4,677.35 |
Hally Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $3,981.07 | Professional | None | $1,548.82 | $2,398.83 | $3,981.07 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $3,630.78 Typical High $8,511.38 | Facility | None | $1,412.54 | $3,630.78 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $3,548.13 Typical High $15,135.61 | Professional | None | $1,949.84 | $3,548.13 | $15,135.61 |
Midlands Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $4,365.16 | Professional | None | $3,162.28 | $3,715.35 | $4,365.16 |
Midlands Setting Facility Modifier None Typical Low $5,754.40 Median $7,244.36 Typical High $8,128.31 | Facility | None | $5,754.40 | $7,244.36 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $5,128.61 | Professional | None | $3,162.28 | $3,715.35 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,584.89 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,691.53 Typical High $4,786.30 | Professional | None | $1,737.80 | $2,691.53 | $4,786.30 |
Wellmark Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,162.28 | $3,715.35 |
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 $794.33 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $794.33 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $316.23 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,174.90 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $234.42 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $158.49 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,905.46 | $1,905.46 |
Where Iowa sits
The same service costs 18.2 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· 6th of 51
$3,388
AK $6,918TX $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.