How much rates vary
Facilitymedian $2,089 · 10th to 90th $562 to $2,630Professionalmedian $2,138 · 10th to 90th $692 to $4,898
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 $407.38 Median $1,819.70 Typical High $4,365.16 | Facility | None | $407.38 | $1,819.70 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $831.76 Typical High $1,778.28 | Professional | None | $331.13 | $831.76 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,235.94 | Facility | None | $1,905.46 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $4,897.79 | Professional | None | $812.83 | $1,380.38 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,089.30 Typical High $2,630.27 | Facility | None | $562.34 | $2,089.30 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $4,168.69 Typical High $13,182.57 | Professional | None | $1,584.89 | $4,168.69 | $13,182.57 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $3,981.07 | Professional | None | $954.99 | $954.99 | $3,981.07 |
Midlands Setting Facility Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $2,630.27 | Facility | None | $1,905.46 | $2,187.76 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $3,801.89 | Professional | None | $812.83 | $912.01 | $3,801.89 |
Sanford Health Plan Setting Professional Modifier None Typical Low $645.65 Median $2,137.96 Typical High $3,388.44 | Professional | None | $645.65 | $2,137.96 | $3,388.44 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $489.78 Median $1,412.54 Typical High $5,128.61 | Professional | None | $489.78 | $1,412.54 | $5,128.61 |
Wellmark Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $4,570.88 | Professional | None | $776.25 | $933.25 | $4,570.88 |
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 $165.96 Median $416.87 Typical High $891.25 | Professional | 52 · Reduced service | $165.96 | $416.87 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $165.96 Typical High $354.81 | Professional | 53 · Discontinued | $67.61 | $165.96 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $630.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $251.19 | $630.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $125.89 Typical High $269.15 | Professional | 55 · Aftercare only | $50.12 | $125.89 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $83.18 Typical High $177.83 | Professional | 56 · Pre-op care only | $33.11 | $83.18 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $588.84 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $234.42 | $588.84 | $1,258.93 |
Where South Dakota sits
The same service costs 4.4 times more in Oklahoma 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
OK $10,373MD $2,367
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.