How much rates vary
Facilitymedian $1,549 · 10th to 90th $832 to $5,129Professionalmedian $1,072 · 10th to 90th $562 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 $831.76 Median $3,235.94 Typical High $6,760.83 | Facility | None | $831.76 | $3,235.94 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $831.76 Typical High $1,202.26 | Professional | None | $489.78 | $831.76 | $1,202.26 |
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 $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,288.25 | Professional | None | $489.78 | $741.31 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $1,348.96 Typical High $4,897.79 | Facility | None | $831.76 | $1,348.96 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,202.26 Typical High $4,365.16 | Professional | None | $588.84 | $1,202.26 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,202.26 | $1,380.38 |
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 $1,000.00 Median $1,202.26 Typical High $1,621.81 | Professional | None | $1,000.00 | $1,202.26 | $1,621.81 |
Oscar Health Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
Oscar Health Setting Professional Modifier None Typical Low $501.19 Median $933.25 Typical High $1,148.15 | Professional | None | $501.19 | $933.25 | $1,148.15 |
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 $512.86 Median $794.33 Typical High $1,412.54 | Professional | None | $512.86 | $794.33 | $1,412.54 |
Wellmark Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,202.26 | Professional | None | $1,023.29 | $1,023.29 | $1,202.26 |
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 $245.47 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $245.47 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $97.72 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $363.08 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $74.13 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $48.98 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $338.84 | $588.84 | $588.84 |
Where Iowa sits
The same service costs 4.0 times more in Colorado than in Maryland. 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 $5,106MD $1,261
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.