How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,905 to $13,490Professionalmedian $3,020 · 10th to 90th $1,660 to $4,169
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 $2,344.23 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,344.23 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,348.96 | $2,344.23 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $10,715.19 Typical High $12,022.64 | Facility | None | $8,511.38 | $10,715.19 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,818.38 | $3,467.37 | $4,168.69 |
Hally Health Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,187.76 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $3,630.78 Typical High $9,772.37 | Facility | None | $1,380.38 | $3,630.78 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,659.59 Median $3,162.28 Typical High $14,791.08 | Professional | None | $1,659.59 | $3,162.28 | $14,791.08 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $3,311.31 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,311.31 | $4,073.80 |
Midlands Setting Facility Modifier None Typical Low $8,511.38 Median $10,715.19 Typical High $12,022.64 | Facility | None | $8,511.38 | $10,715.19 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,786.30 | Professional | None | $2,818.38 | $3,388.44 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,479.11 | $2,238.72 | $3,981.07 |
Wellmark Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,548.13 | Professional | None | $3,019.95 | $3,019.95 | $3,548.13 |
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 $676.08 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $676.08 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $269.15 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,000.00 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $204.17 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $134.90 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $933.25 | $1,621.81 | $1,621.81 |
Where Iowa sits
The same service costs 5.2 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 $16,399KY $3,139
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.