How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,698 to $11,482Professionalmedian $2,344 · 10th to 90th $1,288 to $3,236
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 $1,862.09 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,862.09 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,862.09 | $1,862.09 |
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 $2,290.87 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,691.53 | $3,235.94 |
Hally Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,096.48 | $1,819.70 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $1,659.59 Median $2,951.21 Typical High $7,413.10 | Facility | None | $1,659.59 | $2,951.21 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,630.27 Typical High $9,549.93 | Professional | None | $1,348.96 | $2,630.27 | $9,549.93 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,290.87 | $2,691.53 | $3,235.94 |
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 $2,290.87 Median $2,570.40 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,570.40 | $4,466.84 |
Oscar Health Setting Professional Modifier None Typical Low $1,122.02 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,122.02 | $2,089.30 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,584.89 | $5,011.87 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $3,235.94 | Professional | None | $1,174.90 | $1,819.70 | $3,235.94 |
Wellmark Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,630.27 | Professional | None | $2,238.72 | $2,238.72 | $2,630.27 |
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 $537.03 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $537.03 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $213.80 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $812.83 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $162.18 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $107.15 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $758.58 | $1,288.25 | $1,288.25 |
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
$2,344
AK $4,786TX $550
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.