How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,399 to $13,490Professionalmedian $3,236 · 10th to 90th $1,950 to $4,786
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 $2,630.27 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,630.27 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,548.82 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $7,079.46 Median $8,912.51 Typical High $9,772.37 | Facility | None | $7,079.46 | $8,912.51 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $4,677.35 | Professional | None | $3,311.31 | $3,801.89 | $4,677.35 |
Hally Health Setting Professional Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $4,677.35 | Professional | None | $1,584.89 | $2,570.40 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $3,981.07 Typical High $9,772.37 | Facility | None | $1,380.38 | $3,981.07 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $3,715.35 Typical High $16,982.44 | Professional | None | $1,949.84 | $3,715.35 | $16,982.44 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $4,570.88 | Professional | None | $3,235.94 | $3,801.89 | $4,570.88 |
Midlands Setting Facility Modifier None Typical Low $7,079.46 Median $8,912.51 Typical High $9,772.37 | Facility | None | $7,079.46 | $8,912.51 | $9,772.37 |
Midlands Setting Professional Modifier None Typical Low $3,311.31 Median $3,715.35 Typical High $5,888.44 | Professional | None | $3,311.31 | $3,715.35 | $5,888.44 |
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 $1,698.24 Median $2,570.40 Typical High $4,677.35 | Professional | None | $1,698.24 | $2,570.40 | $4,677.35 |
Wellmark Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,801.89 | Professional | None | $3,235.94 | $3,235.94 | $3,801.89 |
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 $776.25 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $776.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $309.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,148.15 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $229.09 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $154.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,862.09 | $1,862.09 |
Where Iowa sits
The same service costs 9.3 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
$3,467
AK $6,918TX $741
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.