How much rates vary
Facilitymedian $6,607 · 10th to 90th $1,259 to $16,218Professionalmedian $8,318 · 10th to 90th $813 to $16,982
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 $933.25 Median $5,623.41 Typical High $16,218.10 | Facility | None | $933.25 | $5,623.41 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $4,897.79 Typical High $8,317.64 | Professional | None | $478.63 | $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 $1,071.52 Median $7,079.46 Typical High $14,125.38 | Professional | None | $1,071.52 | $7,079.46 | $14,125.38 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $5,248.07 Typical High $7,585.78 | Professional | None | $467.74 | $5,248.07 | $7,585.78 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $8,709.64 Typical High $17,378.01 | Facility | None | $1,148.15 | $8,709.64 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $11,748.98 Typical High $52,480.75 | Professional | None | $1,047.13 | $11,748.98 | $52,480.75 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $10,232.93 Typical High $13,803.84 | Professional | None | $912.01 | $10,232.93 | $13,803.84 |
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 $1,288.25 Median $13,803.84 Typical High $26,915.35 | Professional | None | $1,288.25 | $13,803.84 | $26,915.35 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $11,748.98 | Professional | None | $478.63 | $1,096.48 | $11,748.98 |
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 $549.54 Median $5,248.07 Typical High $15,488.17 | Professional | None | $549.54 | $5,248.07 | $15,488.17 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $14,125.38 | Professional | None | $891.25 | $1,047.13 | $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 $229.09 Median $478.63 Typical High $4,168.69 | Professional | 52 · Reduced service | $229.09 | $478.63 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $194.98 Typical High $1,659.59 | Professional | 53 · Discontinued | $91.20 | $194.98 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $724.44 Typical High $6,165.95 | Professional | 54 · Surgery only | $346.74 | $724.44 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $144.54 Typical High $1,230.27 | Professional | 55 · Aftercare only | $69.18 | $144.54 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $97.72 Typical High $831.76 | Professional | 56 · Pre-op care only | $45.71 | $97.72 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $676.08 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $323.59 | $676.08 | $5,754.40 |
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 $3,466
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.