How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,660 to $11,749Professionalmedian $5,248 · 10th to 90th $3,236 to $7,943
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 $4,168.69 Median $5,011.87 Typical High $7,244.36 | Facility | None | $4,168.69 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $4,365.16 Typical High $4,365.16 | Professional | None | $2,570.40 | $4,365.16 | $4,365.16 |
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 $5,495.41 Median $6,025.60 Typical High $7,762.47 | Professional | None | $5,495.41 | $6,025.60 | $7,762.47 |
Hally Health Setting Professional Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $5,011.87 | Professional | None | $2,570.40 | $4,168.69 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $5,248.07 Typical High $8,511.38 | Facility | None | $1,412.54 | $5,248.07 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $3,235.94 Median $6,165.95 Typical High $32,359.37 | Professional | None | $3,235.94 | $6,165.95 | $32,359.37 |
Midlands Setting Professional Modifier None Typical Low $5,128.61 Median $6,025.60 Typical High $7,244.36 | Professional | None | $5,128.61 | $6,025.60 | $7,244.36 |
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 $5,011.87 Median $5,888.44 Typical High $10,232.93 | Professional | None | $5,011.87 | $5,888.44 | $10,232.93 |
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 $2,818.38 Median $4,265.80 Typical High $7,762.47 | Professional | None | $2,818.38 | $4,265.80 | $7,762.47 |
Wellmark Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,888.44 | Professional | None | $5,011.87 | $5,011.87 | $5,888.44 |
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 $1,288.25 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,288.25 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $512.86 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $1,905.46 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $380.19 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $257.04 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,778.28 | $3,090.30 | $3,090.30 |
Where Iowa sits
The same service costs 20.9 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
$5,370
AK $11,220TX $537
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.