How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,047 to $8,710Professionalmedian $1,230 · 10th to 90th $646 to $1,585
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 $891.25 Median $5,011.87 Typical High $7,244.36 | Facility | None | $891.25 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $891.25 | Professional | None | $512.86 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,288.25 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,288.25 | $1,584.89 |
Hally Health Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,513.56 | Professional | None | $524.81 | $851.14 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,000.00 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,258.93 Typical High $4,168.69 | Professional | None | $645.65 | $1,258.93 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,096.48 | $1,288.25 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,318.26 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,548.82 | Professional | None | $562.34 | $851.14 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,122.02 | $1,122.02 | $1,318.26 |
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 $257.04 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $257.04 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $102.33 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $389.05 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $77.62 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $51.29 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $363.08 | $616.60 | $616.60 |
Where Iowa sits
The same service costs 4.1 times more in Wisconsin 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
WI $7,505MT $1,845
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.