How much rates vary
Facilitymedian $1,413 · 10th to 90th $794 to $5,129Professionalmedian $813 · 10th to 90th $525 to $1,445
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 $602.56 Median $3,388.44 Typical High $6,760.83 | Facility | None | $602.56 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $562.34 Typical High $1,071.52 | Professional | None | $338.84 | $562.34 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,445.44 | Facility | None | $954.99 | $1,230.27 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,288.25 | Professional | None | $776.25 | $870.96 | $1,288.25 |
Hally Health Setting Professional Modifier None Typical Low $309.03 Median $741.31 Typical High $1,318.26 | Professional | None | $309.03 | $741.31 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,318.26 Typical High $4,897.79 | Facility | None | $776.25 | $1,318.26 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $4,073.80 | Professional | None | $645.65 | $1,000.00 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,202.26 | Professional | None | $660.69 | $1,023.29 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,445.44 | Facility | None | $912.01 | $1,230.27 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,445.44 | Professional | None | $645.65 | $977.24 | $1,445.44 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $1,230.27 | Professional | None | $346.74 | $660.69 | $1,230.27 |
United Setting Facility Modifier None Typical Low $724.44 Median $2,884.03 Typical High $5,495.41 | Facility | None | $724.44 | $2,884.03 | $5,495.41 |
United Setting Professional Modifier None Typical Low $371.54 Median $660.69 Typical High $1,288.25 | Professional | None | $371.54 | $660.69 | $1,288.25 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,445.44 | Professional | None | $676.08 | $794.33 | $1,445.44 |
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 $169.82 Median $269.15 Typical High $426.58 | Professional | 52 · Reduced service | $169.82 | $269.15 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $107.15 Typical High $169.82 | Professional | 53 · Discontinued | $67.61 | $107.15 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $398.11 Typical High $645.65 | Professional | 54 · Surgery only | $257.04 | $398.11 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $79.43 Typical High $128.82 | Professional | 55 · Aftercare only | $51.29 | $79.43 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $53.70 Typical High $85.11 | Professional | 56 · Pre-op care only | $33.88 | $53.70 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $371.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $239.88 | $371.54 | $602.56 |
Where Iowa sits
The same service costs 4.4 times more in Colorado than in West Virginia. 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 $4,828WV $1,100
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.