How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,862 to $12,589Professionalmedian $3,090 · 10th to 90th $1,905 to $4,677
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 $2,570.40 Median $5,011.87 Typical High $7,244.36 | Facility | None | $2,570.40 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,513.56 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $8,128.31 | Facility | None | $3,162.28 | $5,754.40 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,548.13 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,548.13 | $4,570.88 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,454.71 Typical High $2,951.21 | Professional | None | $1,513.56 | $2,454.71 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $1,778.28 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,778.28 | $4,466.84 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $16,218.10 | Professional | None | $1,905.46 | $3,548.13 | $16,218.10 |
Midlands Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $4,365.16 | Professional | None | $3,019.95 | $3,548.13 | $4,365.16 |
Midlands Setting Facility Modifier None Typical Low $3,162.28 Median $5,754.40 Typical High $8,128.31 | Facility | None | $3,162.28 | $5,754.40 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $5,888.44 | Professional | None | $2,951.21 | $3,467.37 | $5,888.44 |
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 $1,659.59 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,659.59 | $2,511.89 | $4,570.88 |
Wellmark Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,467.37 | Professional | None | $2,951.21 | $2,951.21 | $3,467.37 |
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 $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $741.31 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $302.00 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,122.02 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $223.87 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $151.36 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,819.70 | $1,819.70 |
Where Iowa sits
The same service costs 20.4 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· 5th of 51
$3,467
AK $6,607TX $324
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.