How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,096 to $8,710Professionalmedian $1,175 · 10th to 90th $646 to $1,622
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 $5,011.87 Typical High $7,943.28 | Facility | None | $933.25 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $933.25 Typical High $1,318.26 | Professional | None | $549.54 | $933.25 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,380.38 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,122.02 | $1,348.96 | $1,621.81 |
Hally Health Setting Professional Modifier None Typical Low $549.54 Median $891.25 Typical High $1,513.56 | Professional | None | $549.54 | $891.25 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $2,344.23 Typical High $8,912.51 | Facility | None | $891.25 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,288.25 Typical High $4,365.16 | Professional | None | $660.69 | $1,288.25 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,318.26 | $1,584.89 |
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 $1,122.02 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,380.38 | $1,949.84 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,318.26 | Professional | None | $562.34 | $1,047.13 | $1,318.26 |
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 $575.44 Median $891.25 Typical High $1,621.81 | Professional | None | $575.44 | $891.25 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
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 $269.15 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $269.15 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $109.65 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $407.38 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 55 · Aftercare only | $81.28 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $54.95 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $380.19 | $660.69 | $660.69 |
Where Iowa sits
The same service costs 3.9 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 $7,471MT $1,932
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.