How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,738 to $12,303Professionalmedian $2,138 · 10th to 90th $1,259 to $3,162
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 $1,737.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,737.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,737.80 | $1,737.80 |
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 $2,137.96 Median $2,398.83 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,398.83 | $3,090.30 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,047.13 | $1,621.81 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,754.23 Typical High $9,332.54 | Facility | None | $1,380.38 | $2,754.23 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,344.23 Typical High $8,511.38 | Professional | None | $1,258.93 | $2,344.23 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,398.83 | $2,818.38 |
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 $2,137.96 Median $2,511.89 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,511.89 | $3,467.37 |
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 $1,122.02 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,698.24 | $3,090.30 |
Wellmark Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | None | $2,137.96 | $2,137.96 | $2,511.89 |
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 $512.86 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $512.86 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $204.17 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $758.58 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $151.36 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $102.33 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $707.95 | $1,230.27 | $1,230.27 |
Where Iowa sits
The same service costs 8.7 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· 7th of 51
$2,291
AK $4,571TX $525
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.