How much rates vary
Facilitymedian $1,514 · 10th to 90th $617 to $4,786Professionalmedian $1,148 · 10th to 90th $617 to $1,549
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 $812.83 Median $3,467.37 Typical High $6,760.83 | Facility | None | $812.83 | $3,467.37 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $812.83 Typical High $1,258.93 | Professional | None | $512.86 | $812.83 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,445.44 Typical High $1,698.24 | Facility | None | $389.05 | $1,445.44 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,202.26 | $1,445.44 |
Hally Health Setting Professional Modifier None Typical Low $478.63 Median $794.33 Typical High $1,230.27 | Professional | None | $478.63 | $794.33 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $1,412.54 Typical High $3,981.07 | Facility | None | $741.31 | $1,412.54 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,230.27 Typical High $4,073.80 | Professional | None | $676.08 | $1,230.27 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,023.29 | $1,202.26 | $1,445.44 |
Midlands Setting Facility Modifier None Typical Low $416.87 Median $1,412.54 Typical High $1,698.24 | Facility | None | $416.87 | $1,412.54 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,445.44 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $588.84 Median $1,071.52 Typical High $1,380.38 | Professional | None | $588.84 | $1,071.52 | $1,380.38 |
United Setting Facility Modifier None Typical Low $501.19 Median $1,949.84 Typical High $4,897.79 | Facility | None | $501.19 | $1,949.84 | $4,897.79 |
United Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,445.44 | Professional | None | $537.03 | $776.25 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,148.15 | $1,318.26 | $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 $251.19 Median $407.38 Typical High $436.52 | Professional | 52 · Reduced service | $251.19 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $102.33 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $380.19 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $75.86 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $81.28 Typical High $87.10 | Professional | 56 · Pre-op care only | $51.29 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $354.81 | $575.44 | $616.60 |
Where Iowa sits
The same service costs 4.0 times more in Colorado 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
CO $4,440FL $1,118
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.