How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,023 to $8,710Professionalmedian $1,000 · 10th to 90th $537 to $1,479
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 $794.33 Median $5,011.87 Typical High $7,244.36 | Facility | None | $794.33 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $794.33 | Professional | None | $457.09 | $794.33 | $794.33 |
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 $954.99 Median $1,148.15 Typical High $1,380.38 | Professional | None | $954.99 | $1,148.15 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $457.09 Median $812.83 Typical High $1,819.70 | Professional | None | $457.09 | $812.83 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,023.29 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,174.90 Typical High $5,011.87 | Professional | None | $562.34 | $1,174.90 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,348.96 | Professional | None | $977.24 | $1,122.02 | $1,348.96 |
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 $954.99 Median $1,148.15 Typical High $2,511.89 | Professional | None | $954.99 | $1,148.15 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $478.63 Median $870.96 Typical High $1,096.48 | Professional | None | $478.63 | $870.96 | $1,096.48 |
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 $489.78 Median $741.31 Typical High $1,348.96 | Professional | None | $489.78 | $741.31 | $1,348.96 |
Wellmark Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | None | $977.24 | $977.24 | $1,148.15 |
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 $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $229.09 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $93.33 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $346.74 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $69.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $45.71 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $323.59 | $549.54 | $549.54 |
Where Iowa sits
The same service costs 4.5 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 $7,285MT $1,607
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.