How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,288 to $8,318Professionalmedian $1,585 · 10th to 90th $891 to $2,455
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 $4,786.30 Typical High $7,244.36 | Facility | None | $1,023.29 | $4,786.30 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $1,023.29 Typical High $1,584.89 | Professional | None | $630.96 | $1,023.29 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,288.25 | $2,398.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,862.09 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $616.60 Median $1,202.26 Typical High $2,511.89 | Professional | None | $616.60 | $1,202.26 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $8,317.64 | Facility | None | $1,318.26 | $2,187.76 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $5,011.87 | Professional | None | $1,174.90 | $1,819.70 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,862.09 | $2,290.87 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $2,398.83 Typical High $3,162.28 | Facility | None | $1,445.44 | $2,398.83 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,778.28 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $10,232.93 | Facility | None | $1,258.93 | $3,630.78 | $10,232.93 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,258.93 Typical High $2,137.96 | Professional | None | $758.58 | $1,258.93 | $2,137.96 |
Wellmark Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,348.96 | $1,949.84 |
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 $316.23 Median $512.86 Typical High $630.96 | Professional | 52 · Reduced service | $316.23 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $204.17 Typical High $251.19 | Professional | 53 · Discontinued | $125.89 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $776.25 Typical High $954.99 | Professional | 54 · Surgery only | $467.74 | $776.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $154.88 Typical High $190.55 | Professional | 55 · Aftercare only | $93.33 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $102.33 Typical High $125.89 | Professional | 56 · Pre-op care only | $63.10 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $724.44 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $436.52 | $724.44 | $891.25 |
Where Iowa sits
The same service costs 3.7 times more in Connecticut than in Arkansas. 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
CT $7,673AR $2,094
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.