How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,778 to $14,125Professionalmedian $2,630 · 10th to 90th $1,549 to $3,890
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 $1,949.84 Median $4,265.80 Typical High $7,244.36 | Facility | None | $1,949.84 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $5,370.32 Typical High $8,128.31 | Facility | None | $1,096.48 | $5,370.32 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,801.89 | Professional | None | $2,630.27 | $3,090.30 | $3,801.89 |
Hally Health Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $3,548.13 | Professional | None | $1,258.93 | $2,089.30 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $15,488.17 | Facility | None | $1,778.28 | $3,801.89 | $15,488.17 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $2,951.21 Typical High $10,715.19 | Professional | None | $1,548.82 | $2,951.21 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $3,090.30 Typical High $3,715.35 | Professional | None | $2,630.27 | $3,090.30 | $3,715.35 |
Midlands Setting Facility Modifier None Typical Low $2,570.40 Median $5,370.32 Typical High $8,128.31 | Facility | None | $2,570.40 | $5,370.32 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,754.23 | $2,951.21 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $22,908.68 | Facility | None | $1,584.89 | $5,011.87 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,348.96 | $2,089.30 | $3,801.89 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,454.71 | $2,454.71 | $2,884.03 |
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 $630.96 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $630.96 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $251.19 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $954.99 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $125.89 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $891.25 | $1,348.96 | $1,348.96 |
Where Iowa sits
The same service costs 7.2 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· 5th of 51
$2,884
AK $5,495TX $759
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.