How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,023 to $7,079Professionalmedian $1,202 · 10th to 90th $646 to $1,698
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 $1,000.00 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,000.00 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $1,000.00 | Professional | None | $575.44 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,041.74 | Facility | None | $1,288.25 | $1,479.11 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,380.38 | $1,737.80 |
Hally Health Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,479.11 | Professional | None | $575.44 | $891.25 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,698.24 Typical High $6,606.93 | Facility | None | $977.24 | $1,698.24 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $4,677.35 | Professional | None | $676.08 | $1,258.93 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,380.38 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,122.02 | $1,513.56 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,445.44 | $1,905.46 |
Oscar Health Setting Professional Modifier None Typical Low $602.56 Median $1,122.02 Typical High $1,412.54 | Professional | None | $602.56 | $1,122.02 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $7,943.28 | Facility | None | $1,479.11 | $3,981.07 | $7,943.28 |
United Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,698.24 | Professional | None | $616.60 | $933.25 | $1,698.24 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
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 $288.40 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $288.40 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $114.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $426.58 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $87.10 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $57.54 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $407.38 | $691.83 | $691.83 |
Where Iowa sits
The same service costs 7.2 times more in Alaska than in Utah. 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· 8th of 51
$1,230
AK $2,570UT $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.