How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,995 to $13,490Professionalmedian $3,467 · 10th to 90th $1,820 to $4,898
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 $2,691.53 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,691.53 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,513.56 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,495.41 | $7,079.46 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,548.13 Typical High $4,786.30 | Professional | None | $3,162.28 | $3,548.13 | $4,786.30 |
Hally Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,621.81 | $2,238.72 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $3,981.07 Typical High $9,772.37 | Facility | None | $1,380.38 | $3,981.07 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,467.37 Typical High $14,454.40 | Professional | None | $1,819.70 | $3,467.37 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $4,265.80 | Professional | None | $3,019.95 | $3,548.13 | $4,265.80 |
Midlands Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,495.41 | $7,079.46 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $4,073.80 Typical High $4,897.79 | Professional | None | $2,818.38 | $4,073.80 | $4,897.79 |
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 $1,659.59 Median $2,454.71 Typical High $4,466.84 | Professional | None | $1,659.59 | $2,454.71 | $4,466.84 |
Wellmark Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $4,365.16 | Professional | None | $3,715.35 | $3,715.35 | $4,365.16 |
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 $758.58 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $758.58 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $302.00 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,148.15 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $229.09 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $151.36 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,862.09 | $1,862.09 |
Where Iowa sits
The same service costs 11.2 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· 7th of 51
$3,548
AK $7,244TX $646
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.