How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,413 to $15,849Professionalmedian $2,138 · 10th to 90th $1,230 to $3,020
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 $5,888.44 Typical High $7,943.28 | Facility | None | $1,737.80 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,000.00 | $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 $2,089.30 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,089.30 | $2,187.76 | $3,019.95 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,584.89 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $2,951.21 Typical High $15,848.93 | Facility | None | $1,412.54 | $2,951.21 | $15,848.93 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,137.96 Typical High $8,128.31 | Professional | None | $1,230.27 | $2,137.96 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $1,862.09 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,187.76 | $2,754.23 |
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 $1,862.09 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,454.71 | $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 $1,071.52 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,071.52 | $1,659.59 | $2,951.21 |
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 $501.19 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $501.19 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $199.53 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $758.58 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $151.36 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $100.00 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $707.95 | $1,202.26 | $1,202.26 |
Where Iowa sits
The same service costs 13.8 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· 7th of 51
$2,138
AK $4,467TX $324
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.