How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,380 to $13,490Professionalmedian $3,890 · 10th to 90th $2,042 to $5,623
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 $3,162.28 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,162.28 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,862.09 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,495.41 | $7,079.46 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,981.07 | $4,570.88 | $5,623.41 |
Hally Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $3,630.78 | Professional | None | $1,548.82 | $1,905.46 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,677.35 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $3,981.07 Typical High $15,135.61 | Professional | None | $2,041.74 | $3,981.07 | $15,135.61 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $5,623.41 | Professional | None | $3,890.45 | $4,570.88 | $5,623.41 |
Midlands Setting Facility Modifier None Typical Low $5,495.41 Median $7,079.46 Typical High $7,762.47 | Facility | None | $5,495.41 | $7,079.46 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $3,388.44 Median $4,073.80 Typical High $5,623.41 | Professional | None | $3,388.44 | $4,073.80 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,819.70 Median $6,309.57 Typical High $19,054.61 | Facility | None | $1,819.70 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $2,951.21 Typical High $5,495.41 | Professional | None | $1,513.56 | $2,951.21 | $5,495.41 |
Wellmark Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,801.89 | $3,801.89 | $4,466.84 |
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 $933.25 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $933.25 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $371.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,380.38 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $275.42 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $186.21 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,288.25 | $2,238.72 | $2,238.72 |
Where Iowa sits
The same service costs 4.9 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 $18,090KY $3,723
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.