How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,259 to $8,710Professionalmedian $1,479 · 10th to 90th $776 to $1,995
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 $1,122.02 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,122.02 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $1,122.02 | Professional | None | $660.69 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,380.38 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,995.26 | Professional | None | $1,288.25 | $1,621.81 | $1,995.26 |
Hally Health Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $2,041.74 | Professional | None | $645.65 | $1,071.52 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,071.52 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,548.82 Typical High $5,370.32 | Professional | None | $794.33 | $1,548.82 | $5,370.32 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,380.38 | $1,513.56 | $1,862.09 |
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 $1,288.25 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,698.24 | $2,630.27 |
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 $691.83 Median $1,047.13 Typical High $1,949.84 | Professional | None | $691.83 | $1,047.13 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,445.44 | $1,737.80 |
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 $331.13 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $331.13 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $131.83 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $489.78 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $100.00 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $66.07 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $457.09 | $794.33 | $794.33 |
Where Iowa sits
The same service costs 3.2 times more in Wisconsin than in Montana. 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 $7,574MT $2,350
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.