How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,514 to $11,749Professionalmedian $2,138 · 10th to 90th $1,259 to $3,162
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 $1,584.89 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,584.89 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,584.89 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,801.89 Typical High $5,128.61 | Facility | None | $954.99 | $3,801.89 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,511.89 | $3,090.30 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,698.24 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $3,467.37 Typical High $15,488.17 | Facility | None | $1,513.56 | $3,467.37 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $8,128.31 | Professional | None | $1,258.93 | $2,454.71 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,137.96 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,511.89 | $3,019.95 |
Midlands Setting Facility Modifier None Typical Low $2,570.40 Median $3,630.78 Typical High $5,128.61 | Facility | None | $2,570.40 | $3,630.78 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $3,715.35 | Professional | None | $2,187.76 | $2,454.71 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $10,715.19 | Facility | None | $1,584.89 | $5,011.87 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,122.02 | $1,698.24 | $3,090.30 |
Wellmark Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,398.83 | Professional | None | $2,041.74 | $2,041.74 | $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 $512.86 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $512.86 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $102.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $724.44 | $1,096.48 | $1,096.48 |
Where Iowa sits
The same service costs 6.2 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· 5th of 51
$2,399
AK $4,571UT $741
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.