How much rates vary
Facilitymedian $794 · 10th to 90th $204 to $2,399Professionalmedian $1,047 · 10th to 90th $525 to $1,349
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 $741.31 Median $2,630.27 Typical High $6,760.83 | Facility | None | $741.31 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,122.02 | Professional | None | $467.74 | $741.31 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $316.23 | Facility | None | $114.82 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,288.25 | Professional | None | $933.25 | $1,096.48 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $426.58 Median $707.95 Typical High $977.24 | Professional | None | $426.58 | $707.95 | $977.24 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,023.29 Typical High $1,621.81 | Facility | None | $239.88 | $1,023.29 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,096.48 Typical High $3,801.89 | Professional | None | $575.44 | $1,096.48 | $3,801.89 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,288.25 | Professional | None | $912.01 | $1,071.52 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $316.23 | Facility | None | $123.03 | $223.87 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $1,288.25 Typical High $1,380.38 | Professional | None | $870.96 | $1,288.25 | $1,380.38 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,174.90 | Professional | None | $489.78 | $891.25 | $1,174.90 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $467.74 Median $691.83 Typical High $1,288.25 | Professional | None | $467.74 | $691.83 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,348.96 | Professional | None | $954.99 | $1,122.02 | $1,348.96 |
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 $371.54 Typical High $398.11 | Professional | 52 · Reduced service | $229.09 | $371.54 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $147.91 Typical High $158.49 | Professional | 53 · Discontinued | $93.33 | $147.91 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $346.74 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $69.18 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $74.13 Typical High $79.43 | Professional | 56 · Pre-op care only | $45.71 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $323.59 | $512.86 | $562.34 |
Where Iowa sits
The same service costs 4.7 times more in New York than in Florida. 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
NY $3,038FL $649
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.