How much rates vary
Facilitymedian $832 · 10th to 90th $204 to $2,455Professionalmedian $1,096 · 10th to 90th $562 to $1,445
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 $776.25 Median $2,630.27 Typical High $6,760.83 | Facility | None | $776.25 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $831.76 | Professional | None | $457.09 | $776.25 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $316.23 | Facility | None | $114.82 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,348.96 | Professional | None | $977.24 | $1,148.15 | $1,348.96 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,023.29 | Professional | None | $457.09 | $741.31 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,023.29 Typical High $1,621.81 | Facility | None | $239.88 | $1,023.29 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $3,890.45 | Professional | None | $602.56 | $1,148.15 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | None | $954.99 | $1,122.02 | $1,348.96 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $316.23 | Facility | None | $123.03 | $223.87 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,445.44 | Professional | None | $912.01 | $1,348.96 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $512.86 Median $933.25 Typical High $1,258.93 | Professional | None | $512.86 | $933.25 | $1,258.93 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,348.96 | Professional | None | $489.78 | $724.44 | $1,348.96 |
Wellmark Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,174.90 | $1,412.54 |
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 $245.47 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $245.47 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $97.72 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $363.08 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $72.44 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $48.98 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $338.84 | $549.54 | $588.84 |
Where Iowa sits
The same service costs 5.8 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· 3rd of 51
$1,096
AK $2,042TX $355
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.