How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,549 to $12,589Professionalmedian $2,630 · 10th to 90th $1,514 to $3,890
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 $2,137.96 Median $5,888.44 Typical High $7,943.28 | Facility | None | $2,137.96 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,230.27 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $4,897.79 Typical High $6,309.57 | Facility | None | $3,162.28 | $4,897.79 | $6,309.57 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,691.53 | $2,884.03 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,862.09 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $3,630.78 Typical High $12,589.25 | Facility | None | $1,548.82 | $3,630.78 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $14,791.08 | Professional | None | $1,513.56 | $2,818.38 | $14,791.08 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,884.03 | $3,388.44 |
Midlands Setting Facility Modifier None Typical Low $3,162.28 Median $4,897.79 Typical High $6,309.57 | Facility | None | $3,162.28 | $4,897.79 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,398.83 | $3,019.95 | $3,981.07 |
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 $1,380.38 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,380.38 | $1,995.26 | $3,801.89 |
Wellmark Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,630.27 | $2,630.27 | $3,090.30 |
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 $616.60 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $616.60 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $251.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $933.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $186.21 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $870.96 | $1,479.11 | $1,479.11 |
Where Iowa sits
The same service costs 17.0 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
$2,754
AK $5,495TX $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.