How much rates vary
Facilitymedian $6,310 · 10th to 90th $2,692 to $19,498Professionalmedian $4,169 · 10th to 90th $2,455 to $6,026
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 $3,311.31 Median $6,165.95 Typical High $9,332.54 | Facility | None | $3,311.31 | $6,165.95 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,949.84 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $13,803.84 Median $17,782.79 Typical High $19,498.45 | Facility | None | $13,803.84 | $17,782.79 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $4,168.69 Median $4,786.30 Typical High $5,888.44 | Professional | None | $4,168.69 | $4,786.30 | $5,888.44 |
Hally Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,162.28 Typical High $3,715.35 | Professional | None | $1,995.26 | $3,162.28 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $2,454.71 Median $5,011.87 Typical High $12,882.50 | Facility | None | $2,454.71 | $5,011.87 | $12,882.50 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $4,677.35 Typical High $31,622.78 | Professional | None | $2,454.71 | $4,677.35 | $31,622.78 |
Midlands Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,888.44 | Professional | None | $4,073.80 | $4,786.30 | $5,888.44 |
Midlands Setting Facility Modifier None Typical Low $13,803.84 Median $17,782.79 Typical High $19,498.45 | Facility | None | $13,803.84 | $17,782.79 | $19,498.45 |
Midlands Setting Professional Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $7,585.78 | Professional | None | $4,168.69 | $4,570.88 | $7,585.78 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,232.93 Typical High $46,773.51 | Facility | None | $2,630.27 | $10,232.93 | $46,773.51 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,888.44 | Professional | None | $2,137.96 | $3,311.31 | $5,888.44 |
Wellmark Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,677.35 | Professional | None | $3,981.07 | $3,981.07 | $4,677.35 |
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 $977.24 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $977.24 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $389.05 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,445.44 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $288.40 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $194.98 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,348.96 | $2,344.23 | $2,344.23 |
Where Iowa sits
The same service costs 6.5 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· 5th of 51
$4,365
AK $8,710TX $1,349
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.