How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,380 to $8,710Professionalmedian $1,778 · 10th to 90th $933 to $2,455
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 $1,412.54 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,412.54 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $1,412.54 Typical High $1,412.54 | Professional | None | $812.83 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,288.25 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,454.71 | Professional | None | $1,698.24 | $2,041.74 | $2,454.71 |
Hally Health Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $2,630.27 | Professional | None | $812.83 | $1,348.96 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $8,912.51 | Facility | None | $1,380.38 | $2,398.83 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $6,760.83 | Professional | None | $1,000.00 | $1,995.26 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,737.80 | $1,995.26 | $2,344.23 |
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 $1,659.59 Median $2,041.74 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,041.74 | $3,388.44 |
Oscar Health Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $1,995.26 | Professional | None | $851.14 | $1,584.89 | $1,995.26 |
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 $870.96 Median $1,348.96 Typical High $2,454.71 | Professional | None | $870.96 | $1,348.96 | $2,454.71 |
Wellmark Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
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 $407.38 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $407.38 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $162.18 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $616.60 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $123.03 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $81.28 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $575.44 | $977.24 | $977.24 |
Where Iowa sits
The same service costs 3.0 times more in Wisconsin 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
WI $7,993MD $2,690
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.