How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,778 to $12,303Professionalmedian $2,188 · 10th to 90th $1,288 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 $1,778.28 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,778.28 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $9,549.93 Typical High $10,471.29 | Facility | None | $7,413.10 | $9,549.93 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,570.40 | $3,090.30 |
Hally Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,778.28 | $3,090.30 |
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 $1,288.25 Median $2,511.89 Typical High $8,317.64 | Professional | None | $1,288.25 | $2,511.89 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,570.40 | $3,090.30 |
Midlands Setting Facility Modifier None Typical Low $7,413.10 Median $9,549.93 Typical High $10,471.29 | Facility | None | $7,413.10 | $9,549.93 | $10,471.29 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $3,890.45 | Professional | None | $2,187.76 | $2,511.89 | $3,890.45 |
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 $2,570.40 | Professional | None | $2,137.96 | $2,137.96 | $2,570.40 |
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 $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $512.86 | $891.25 | $891.25 |
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 $776.25 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $776.25 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $154.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $102.33 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $724.44 | $1,230.27 | $1,230.27 |
Where Iowa sits
The same service costs 5.1 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 $14,343KY $2,808
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.