How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,778 to $12,882Professionalmedian $2,344 · 10th to 90th $1,202 to $3,631
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 $1,000.00 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,000.00 | $1,778.28 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,011.87 Typical High $7,585.78 | Facility | None | $1,380.38 | $5,011.87 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,122.02 | $2,398.83 | $2,951.21 |
Hally Health Setting Professional Modifier None Typical Low $977.24 Median $1,698.24 Typical High $5,248.07 | Professional | None | $977.24 | $1,698.24 | $5,248.07 |
Medica Setting Facility Modifier None Typical Low $1,778.28 Median $3,467.37 Typical High $14,454.40 | Facility | None | $1,778.28 | $3,467.37 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,344.23 Typical High $11,481.54 | Professional | None | $1,288.25 | $2,344.23 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,398.83 | $2,951.21 |
Midlands Setting Facility Modifier None Typical Low $3,162.28 Median $5,011.87 Typical High $7,079.46 | Facility | None | $3,162.28 | $5,011.87 | $7,079.46 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $3,311.31 | Professional | None | $1,905.46 | $2,691.53 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $15,488.17 | Facility | None | $1,584.89 | $5,011.87 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,548.82 | $2,951.21 |
Wellmark Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,398.83 | Professional | None | $2,137.96 | $2,137.96 | $2,398.83 |
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 $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $501.19 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $199.53 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $741.31 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $147.91 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $100.00 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $691.83 | $1,258.93 | $1,258.93 |
Where Iowa sits
The same service costs 6.2 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· 6th of 51
$2,344
AK $4,365TX $708
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.