How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,514 to $14,791Professionalmedian $1,660 · 10th to 90th $891 to $2,291
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 $1,288.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,288.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,995.26 | Professional | None | $758.58 | $1,288.25 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,888.44 Typical High $7,244.36 | Facility | None | $1,380.38 | $5,888.44 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,584.89 | $1,862.09 | $2,290.87 |
Hally Health Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $2,454.71 | Professional | None | $758.58 | $1,318.26 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $3,548.13 Typical High $17,378.01 | Facility | None | $1,513.56 | $3,548.13 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $1,819.70 Typical High $6,025.60 | Professional | None | $933.25 | $1,819.70 | $6,025.60 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,862.09 | $2,238.72 |
Midlands Setting Facility Modifier None Typical Low $3,388.44 Median $5,888.44 Typical High $7,244.36 | Facility | None | $3,388.44 | $5,888.44 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,862.09 | $3,162.28 |
Oscar Health Setting Professional Modifier None Typical Low $776.25 Median $1,445.44 Typical High $1,819.70 | Professional | None | $776.25 | $1,445.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,584.89 | $5,011.87 | $19,054.61 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $2,238.72 | Professional | None | $812.83 | $1,230.27 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
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 $371.54 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $371.54 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $151.36 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $562.34 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $112.20 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $75.86 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $524.81 | $912.01 | $912.01 |
Where Iowa sits
The same service costs 5.9 times more in Colorado than in West Virginia. 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
CO $14,031WV $2,390
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.