How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,096 to $9,333Professionalmedian $1,288 · 10th to 90th $661 to $1,905
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 $537.03 Median $1,000.00 Typical High $1,000.00 | Professional | None | $537.03 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $3,388.44 | Facility | None | $2,344.23 | $2,818.38 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $1,380.38 Typical High $1,659.59 | Professional | None | $645.65 | $1,380.38 | $1,659.59 |
Hally Health Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $2,344.23 | Professional | None | $562.34 | $870.96 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $2,511.89 Typical High $9,549.93 | Facility | None | $891.25 | $2,511.89 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,348.96 Typical High $4,677.35 | Professional | None | $691.83 | $1,348.96 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,380.38 | $1,659.59 |
Midlands Setting Facility Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $3,388.44 | Facility | None | $2,137.96 | $2,818.38 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,513.56 | $1,862.09 |
Oscar Health Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,445.44 | Professional | None | $616.60 | $1,148.15 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $10,000.00 | Facility | None | $1,380.38 | $4,365.16 | $10,000.00 |
United Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,621.81 | Professional | None | $630.96 | $851.14 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,445.44 | Professional | None | $1,288.25 | $1,288.25 | $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 $275.42 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $275.42 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $109.65 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $416.87 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $83.18 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $54.95 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $389.05 | $691.83 | $691.83 |
Where Iowa sits
The same service costs 5.9 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· 5th of 51
$1,349
AK $2,455TX $417
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.