How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,096 to $6,026Professionalmedian $1,479 · 10th to 90th $813 to $2,291
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 $1,023.29 Median $4,168.69 Typical High $7,244.36 | Facility | None | $1,023.29 | $4,168.69 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,288.25 | Professional | None | $645.65 | $1,023.29 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,862.09 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $1,071.52 Typical High $1,479.11 | Professional | None | $616.60 | $1,071.52 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $5,623.41 | Facility | None | $1,047.13 | $1,862.09 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,778.28 Typical High $5,011.87 | Professional | None | $954.99 | $1,778.28 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,513.56 | $1,862.09 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,737.80 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,311.31 Typical High $6,456.54 | Facility | None | $1,258.93 | $3,311.31 | $6,456.54 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $2,137.96 | Professional | None | $724.44 | $1,071.52 | $2,137.96 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,348.96 | $1,737.80 |
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 $323.59 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $323.59 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $204.17 Typical High $257.04 | Professional | 53 · Discontinued | $131.83 | $204.17 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $489.78 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $97.72 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $102.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $64.57 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $724.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $457.09 | $724.44 | $891.25 |
Where Iowa sits
The same service costs 3.1 times more in Alaska than in Maryland. 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
AK $5,990MD $1,938
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.