How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,096 to $8,710Professionalmedian $977 · 10th to 90th $490 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 $707.95 Median $4,265.80 Typical High $7,244.36 | Facility | None | $707.95 | $4,265.80 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $1,071.52 | Professional | None | $426.58 | $707.95 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,258.93 | Professional | None | $851.14 | $1,023.29 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $407.38 Median $724.44 Typical High $2,041.74 | Professional | None | $407.38 | $724.44 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $2,344.23 Typical High $8,912.51 | Facility | None | $977.24 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,096.48 Typical High $5,248.07 | Professional | None | $489.78 | $1,096.48 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,174.90 | Professional | None | $851.14 | $1,000.00 | $1,174.90 |
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 $851.14 Median $1,000.00 Typical High $2,754.23 | Professional | None | $851.14 | $1,000.00 | $2,754.23 |
Oscar Health Setting Professional Modifier None Typical Low $416.87 Median $776.25 Typical High $954.99 | Professional | None | $416.87 | $776.25 | $954.99 |
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 $436.52 Median $691.83 Typical High $1,230.27 | Professional | None | $436.52 | $691.83 | $1,230.27 |
Wellmark Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,023.29 | Professional | None | $870.96 | $870.96 | $1,023.29 |
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 $204.17 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $204.17 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $81.28 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $309.03 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $61.66 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $40.74 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $288.40 | $489.78 | $489.78 |
Where Iowa sits
The same service costs 5.0 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 $7,200MT $1,432
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.