How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,380 to $12,589Professionalmedian $1,514 · 10th to 90th $891 to $2,291
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 $1,258.93 Median $6,760.83 Typical High $10,471.29 | Facility | None | $1,258.93 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,258.93 Typical High $1,258.93 | Professional | None | $741.31 | $1,258.93 | $1,258.93 |
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 $1,548.82 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,778.28 | $2,187.76 |
Hally Health Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,949.84 | Professional | None | $724.44 | $1,148.15 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $3,388.44 Typical High $12,589.25 | Facility | None | $1,348.96 | $3,388.44 | $12,589.25 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $6,918.31 | Professional | None | $912.01 | $1,659.59 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,513.56 | $1,778.28 | $2,137.96 |
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 $1,548.82 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,548.82 | $1,737.80 | $2,454.71 |
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 $794.33 Median $1,230.27 Typical High $2,238.72 | Professional | None | $794.33 | $1,230.27 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,479.11 | $1,479.11 | $1,737.80 |
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 $371.54 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $371.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $147.91 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $549.54 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $109.65 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $74.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $512.86 | $891.25 | $891.25 |
Where Iowa sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,315KY $2,095
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.