How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,585 to $13,183Professionalmedian $2,344 · 10th to 90th $1,413 to $3,467
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 $5,888.44 Typical High $7,943.28 | Facility | None | $1,949.84 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $8,128.31 | Facility | None | $5,754.40 | $7,413.10 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $3,388.44 | Professional | None | $2,398.83 | $2,818.38 | $3,388.44 |
Hally Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,819.70 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $3,311.31 Typical High $13,182.57 | Facility | None | $1,584.89 | $3,311.31 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $2,570.40 Typical High $14,791.08 | Professional | None | $1,412.54 | $2,570.40 | $14,791.08 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,344.23 | $2,818.38 | $3,311.31 |
Midlands Setting Facility Modifier None Typical Low $5,754.40 Median $7,413.10 Typical High $8,128.31 | Facility | None | $5,754.40 | $7,413.10 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,890.45 | Professional | None | $2,344.23 | $2,691.53 | $3,890.45 |
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 $1,230.27 Median $1,905.46 Typical High $3,467.37 | Professional | None | $1,230.27 | $1,905.46 | $3,467.37 |
Wellmark Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
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 $562.34 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $562.34 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $223.87 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $851.14 | $1,445.44 | $1,445.44 |
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 $112.20 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $112.20 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $794.33 | $1,348.96 | $1,348.96 |
Where Iowa sits
The same service costs 16.2 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
$2,570
AK $5,012TX $309
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.