How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,660 to $15,136Professionalmedian $2,188 · 10th to 90th $1,259 to $3,162
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 $1,778.28 Median $5,888.44 Typical High $7,943.28 | Facility | None | $1,778.28 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $14,454.40 | Facility | None | $10,232.93 | $12,882.50 | $14,454.40 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,570.40 | $3,090.30 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,621.81 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $9,772.37 | Facility | None | $1,380.38 | $2,754.23 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $8,317.64 | Professional | None | $1,258.93 | $2,344.23 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,570.40 | $3,019.95 |
Midlands Setting Facility Modifier None Typical Low $10,232.93 Median $12,882.50 Typical High $14,454.40 | Facility | None | $10,232.93 | $12,882.50 | $14,454.40 |
Midlands Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,548.13 | Professional | None | $2,137.96 | $2,511.89 | $3,548.13 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $33,884.42 | Facility | None | $1,819.70 | $6,309.57 | $33,884.42 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,698.24 | $3,090.30 |
Wellmark Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
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 $512.86 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $512.86 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $204.17 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $758.58 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $154.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $102.33 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $707.95 | $1,230.27 | $1,230.27 |
Where Iowa sits
The same service costs 8.3 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· 6th of 51
$2,291
AK $4,571TX $550
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.