How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,349 to $15,849Professionalmedian $8,318 · 10th to 90th $912 to $17,378
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 $794.33 Median $5,623.41 Typical High $8,317.64 | Facility | None | $794.33 | $5,623.41 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $4,897.79 Typical High $8,317.64 | Professional | None | $489.78 | $4,897.79 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $7,762.47 | Facility | None | $5,128.61 | $6,165.95 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $6,309.57 Typical High $14,125.38 | Professional | None | $1,148.15 | $6,309.57 | $14,125.38 |
Hally Health Setting Professional Modifier None Typical Low $501.19 Median $5,248.07 Typical High $8,128.31 | Professional | None | $501.19 | $5,248.07 | $8,128.31 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $8,709.64 Typical High $17,378.01 | Facility | None | $1,230.27 | $8,709.64 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $11,748.98 Typical High $52,480.75 | Professional | None | $1,122.02 | $11,748.98 | $52,480.75 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $10,232.93 Typical High $14,125.38 | Professional | None | $977.24 | $10,232.93 | $14,125.38 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $6,165.95 Typical High $7,762.47 | Facility | None | $4,073.80 | $6,165.95 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $13,803.84 Typical High $26,915.35 | Professional | None | $1,380.38 | $13,803.84 | $26,915.35 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,309.57 Typical High $19,054.61 | Facility | None | $2,398.83 | $6,309.57 | $19,054.61 |
United Setting Professional Modifier None Typical Low $588.84 Median $5,370.32 Typical High $15,488.17 | Professional | None | $588.84 | $5,370.32 | $15,488.17 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $14,125.38 | Professional | None | $954.99 | $1,122.02 | $14,125.38 |
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 $245.47 Median $524.81 Typical High $4,168.69 | Professional | 52 · Reduced service | $245.47 | $524.81 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $208.93 Typical High $1,659.59 | Professional | 53 · Discontinued | $97.72 | $208.93 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $776.25 Typical High $6,309.57 | Professional | 54 · Surgery only | $363.08 | $776.25 | $6,309.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $154.88 Typical High $1,258.93 | Professional | 55 · Aftercare only | $74.13 | $154.88 | $1,258.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $104.71 Typical High $831.76 | Professional | 56 · Pre-op care only | $48.98 | $104.71 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $724.44 Typical High $5,888.44 | Professional | 78 · Unplanned return to OR | $338.84 | $724.44 | $5,888.44 |
Where Iowa sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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 $20,151MS $3,493
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.