How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,585 to $26,303Professionalmedian $1,950 · 10th to 90th $1,148 to $2,884
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 $1,584.89 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,584.89 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,584.89 Typical High $1,584.89 | Professional | None | $912.01 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $11,220.18 Typical High $13,182.57 | Facility | None | $1,380.38 | $11,220.18 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,905.46 | $2,290.87 | $2,754.23 |
Hally Health Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,754.23 | Professional | None | $933.25 | $1,513.56 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $4,677.35 Typical High $26,302.68 | Facility | None | $1,584.89 | $4,677.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $7,413.10 | Professional | None | $1,148.15 | $2,238.72 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,290.87 | $2,691.53 |
Midlands Setting Facility Modifier None Typical Low $5,754.40 Median $10,964.78 Typical High $13,182.57 | Facility | None | $5,754.40 | $10,964.78 | $13,182.57 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,238.72 | $3,467.37 |
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 $1,000.00 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,513.56 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,949.84 | $1,949.84 | $2,290.87 |
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 $457.09 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $457.09 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $181.97 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $691.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $138.04 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $91.20 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $645.65 | $1,096.48 | $1,096.48 |
Where Iowa sits
The same service costs 8.5 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
$2,239
AK $4,074TX $479
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.