How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,778 to $13,183Professionalmedian $4,169 · 10th to 90th $2,455 to $6,310
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 $3,467.37 Median $5,888.44 Typical High $7,943.28 | Facility | None | $3,467.37 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,041.74 | $3,467.37 | $3,467.37 |
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 $4,466.84 Median $4,570.88 Typical High $6,165.95 | Professional | None | $4,466.84 | $4,570.88 | $6,165.95 |
Hally Health Setting Professional Modifier None Typical Low $2,041.74 Median $3,090.30 Typical High $5,128.61 | Professional | None | $2,041.74 | $3,090.30 | $5,128.61 |
Medica Setting Facility Modifier None Typical Low $1,659.59 Median $4,677.35 Typical High $13,182.57 | Facility | None | $1,659.59 | $4,677.35 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $4,466.84 Typical High $24,547.09 | Professional | None | $2,454.71 | $4,466.84 | $24,547.09 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,890.45 | $4,570.88 | $5,623.41 |
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 $3,630.78 Median $4,897.79 Typical High $6,606.93 | Professional | None | $3,630.78 | $4,897.79 | $6,606.93 |
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 $2,238.72 Median $3,311.31 Typical High $6,165.95 | Professional | None | $2,238.72 | $3,311.31 | $6,165.95 |
Wellmark Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $5,011.87 | Professional | None | $4,168.69 | $4,168.69 | $5,011.87 |
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 $1,023.29 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,023.29 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $407.38 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,513.56 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $302.00 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $204.17 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,412.54 | $2,454.71 | $2,454.71 |
Where Iowa sits
The same service costs 21.4 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· 7th of 51
$4,365
AK $9,120TX $427
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.