How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,698 to $13,183Professionalmedian $2,344 · 10th to 90th $1,445 to $3,631
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 $1,949.84 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,949.84 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $6,309.57 | Facility | None | $4,786.30 | $5,754.40 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,754.23 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,122.02 | $1,862.09 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $1,659.59 Median $3,311.31 Typical High $13,182.57 | Facility | None | $1,659.59 | $3,311.31 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,691.53 Typical High $14,791.08 | Professional | None | $1,445.44 | $2,691.53 | $14,791.08 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,754.23 | $3,311.31 |
Midlands Setting Facility Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $6,309.57 | Facility | None | $4,786.30 | $5,754.40 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,691.53 | $4,168.69 |
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 $1,258.93 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,905.46 | $3,467.37 |
Wellmark Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,290.87 | $2,290.87 | $2,691.53 |
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 $575.44 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $575.44 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $229.09 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $851.14 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $169.82 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $114.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $794.33 | $1,380.38 | $1,380.38 |
Where Iowa sits
The same service costs 14.5 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· 5th of 51
$2,692
AK $4,898TX $339
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.