How much rates vary
Facilitymedian $2,399 · 10th to 90th $832 to $7,244Professionalmedian $741 · 10th to 90th $398 to $1,175
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 $602.56 Median $4,265.80 Typical High $7,244.36 | Facility | None | $602.56 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $537.03 Typical High $676.08 | Professional | None | $309.03 | $537.03 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,096.48 | $1,995.26 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $1,071.52 | Professional | None | $707.95 | $758.58 | $1,071.52 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $562.34 Typical High $1,621.81 | Professional | None | $316.23 | $562.34 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,698.24 Typical High $7,079.46 | Facility | None | $776.25 | $1,698.24 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $870.96 Typical High $3,311.31 | Professional | None | $436.52 | $870.96 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $891.25 | Professional | None | $645.65 | $758.58 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,454.71 | Facility | None | $1,230.27 | $1,995.26 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $2,041.74 | Professional | None | $707.95 | $891.25 | $2,041.74 |
Oscar Health Setting Professional Modifier None Typical Low $316.23 Median $588.84 Typical High $741.31 | Professional | None | $316.23 | $588.84 | $741.31 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $7,762.47 | Facility | None | $1,258.93 | $3,630.78 | $7,762.47 |
United Setting Professional Modifier None Typical Low $346.74 Median $676.08 Typical High $1,122.02 | Professional | None | $346.74 | $676.08 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | None | $630.96 | $630.96 | $741.31 |
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 $154.88 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $154.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $61.66 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $234.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $46.77 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $30.90 | $53.70 | $53.70 |
Where Iowa sits
The same service costs 6.1 times more in Oklahoma 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
OK $6,602MT $1,074
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.