How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,047 to $8,710Professionalmedian $2,399 · 10th to 90th $1,096 to $3,467
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 $1,949.84 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,949.84 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $3,467.37 | Facility | None | $954.99 | $2,630.27 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,454.71 | $3,467.37 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $2,238.72 | Professional | None | $977.24 | $1,174.90 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $9,549.93 | Facility | None | $891.25 | $3,019.95 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,290.87 Typical High $9,332.54 | Professional | None | $1,096.48 | $2,290.87 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,162.28 | Professional | None | $2,089.30 | $2,454.71 | $3,162.28 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,148.15 | $2,511.89 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,778.28 Typical High $3,388.44 | Professional | None | $794.33 | $1,778.28 | $3,388.44 |
Wellmark Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,398.83 | $2,398.83 | $2,818.38 |
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 $575.44 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $575.44 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $229.09 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $851.14 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $169.82 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $114.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $794.33 | $1,380.38 | $1,380.38 |
Where Iowa sits
The same service costs 3.7 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 $9,494KY $2,537
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.