How much rates vary
Facilitymedian $339 · 10th to 90th $126 to $2,042Professionalmedian $166 · 10th to 90th $89 to $309
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 $89.13 Median $194.98 Typical High $6,606.93 | Facility | None | $89.13 | $194.98 | $6,606.93 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $109.65 Typical High $190.55 | Professional | None | $60.26 | $109.65 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $91.20 | Facility | None | $85.11 | $85.11 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $316.23 | Professional | None | $131.83 | $190.55 | $316.23 |
Hally Health Setting Professional Modifier None Typical Low $54.95 Median $154.88 Typical High $302.00 | Professional | None | $54.95 | $154.88 | $302.00 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $288.40 Typical High $1,348.96 | Facility | None | $128.82 | $288.40 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $213.80 Typical High $501.19 | Professional | None | $125.89 | $213.80 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $295.12 | Professional | None | $131.83 | $218.78 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $91.20 Typical High $97.72 | Facility | None | $85.11 | $91.20 | $97.72 |
Oscar Health Setting Facility Modifier None Typical Low $147.91 Median $1,479.11 Typical High $2,137.96 | Facility | None | $147.91 | $1,479.11 | $2,137.96 |
Oscar Health Setting Professional Modifier None Typical Low $66.07 Median $141.25 Typical High $295.12 | Professional | None | $66.07 | $141.25 | $295.12 |
United Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,995.26 | Facility | None | $223.87 | $616.60 | $1,995.26 |
United Setting Professional Modifier None Typical Low $67.61 Median $147.91 Typical High $269.15 | Professional | None | $67.61 | $147.91 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $275.42 | Professional | None | $114.82 | $125.89 | $275.42 |
5 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 $26.92 Median $43.65 Typical High $85.11 | Professional | 52 · Reduced service | $26.92 | $43.65 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.78 Typical High $34.67 | Professional | 53 · Discontinued | $10.96 | $17.78 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $66.07 Typical High $128.82 | Professional | 54 · Surgery only | $40.74 | $66.07 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.18 Typical High $25.70 | Professional | 55 · Aftercare only | $8.13 | $13.18 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.91 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.50 | $8.91 | $17.38 |
Where Iowa sits
The same service costs 12.9 times more in Colorado than in Maine. 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.
Physician feeFacility fee
CO $2,408ME $187
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.