How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,318 to $8,710Professionalmedian $1,862 · 10th to 90th $1,023 to $2,570
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 $1,445.44 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,445.44 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $1,445.44 | Professional | None | $851.14 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,570.40 | Professional | None | $1,659.59 | $2,089.30 | $2,570.40 |
Hally Health Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,511.89 | Professional | None | $831.76 | $1,380.38 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $8,912.51 | Facility | None | $1,318.26 | $2,511.89 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $2,041.74 Typical High $6,918.31 | Professional | None | $1,023.29 | $2,041.74 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,778.28 | $1,949.84 | $2,398.83 |
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 $1,698.24 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,187.76 | $3,235.94 |
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 $891.25 Median $1,348.96 Typical High $2,511.89 | Professional | None | $891.25 | $1,348.96 | $2,511.89 |
Wellmark Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
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 $426.58 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $426.58 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $169.82 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $630.96 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $125.89 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $85.11 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $588.84 | $1,023.29 | $1,023.29 |
Where Iowa sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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 $8,167HI $2,648
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.