How much rates vary
Facilitymedian $1,862 · 10th to 90th $513 to $5,495Professionalmedian $525 · 10th to 90th $309 to $955
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 $512.86 Median $3,388.44 Typical High $6,760.83 | Facility | None | $512.86 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $512.86 | Professional | None | $208.93 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $1,778.28 Typical High $2,344.23 | Facility | None | $380.19 | $1,778.28 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $954.99 | Professional | None | $501.19 | $616.60 | $954.99 |
Hally Health Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $588.84 | Professional | None | $204.17 | $363.08 | $588.84 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $4,897.79 | Facility | None | $478.63 | $891.25 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $1,621.81 | Professional | None | $389.05 | $602.56 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $851.14 | Professional | None | $524.81 | $616.60 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $1,737.80 Typical High $2,344.23 | Facility | None | $380.19 | $1,737.80 | $2,344.23 |
United Setting Facility Modifier None Typical Low $724.44 Median $3,090.30 Typical High $6,165.95 | Facility | None | $724.44 | $3,090.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $263.03 Median $457.09 Typical High $794.33 | Professional | None | $263.03 | $457.09 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $724.44 | Professional | None | $389.05 | $436.52 | $724.44 |
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 $104.71 Median $169.82 Typical High $257.04 | Professional | 52 · Reduced service | $104.71 | $169.82 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $67.61 Typical High $102.33 | Professional | 53 · Discontinued | $41.69 | $67.61 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $251.19 Typical High $389.05 | Professional | 54 · Surgery only | $158.49 | $251.19 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $50.12 Typical High $77.62 | Professional | 55 · Aftercare only | $31.62 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.88 Typical High $51.29 | Professional | 56 · Pre-op care only | $20.89 | $33.88 | $51.29 |
Where Iowa sits
The same service costs 6.1 times more in Michigan than in Montana. 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
MI $4,783MT $790
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.