How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,230 to $10,965Professionalmedian $1,175 · 10th to 90th $851 to $7,943
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 $1,122.02 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,122.02 | $4,466.84 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $4,677.35 | Facility | None | $630.96 | $3,981.07 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,258.93 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $10,715.19 | Facility | None | $1,348.96 | $2,238.72 | $10,715.19 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $7,943.28 | Professional | None | $891.25 | $1,174.90 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $5,754.40 Typical High $11,220.18 | Facility | None | $1,621.81 | $5,754.40 | $11,220.18 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,548.82 | Professional | None | $851.14 | $1,071.52 | $1,548.82 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Oklahoma sits
The same service costs 5.1 times more in Colorado than in Hawaii. 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 $14,362HI $2,794
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.