How much rates vary
Facilitymedian $2,951 · 10th to 90th $891 to $8,318Professionalmedian $955 · 10th to 90th $513 to $1,318
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 $758.58 Median $6,760.83 Typical High $10,471.29 | Facility | None | $758.58 | $6,760.83 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,174.90 | Professional | None | $446.68 | $758.58 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,862.09 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,318.26 | Professional | None | $912.01 | $1,096.48 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,258.93 | Professional | None | $436.52 | $724.44 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $794.33 Median $1,949.84 Typical High $8,317.64 | Facility | None | $794.33 | $1,949.84 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $1,071.52 Typical High $3,548.13 | Professional | None | $537.03 | $1,071.52 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,288.25 | Professional | None | $933.25 | $1,071.52 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $1,862.09 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,862.09 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $457.09 Median $851.14 Typical High $1,047.13 | Professional | None | $457.09 | $851.14 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,630.78 | $8,709.64 |
United Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $1,318.26 | Professional | None | $467.74 | $707.95 | $1,318.26 |
Wellmark Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | None | $954.99 | $954.99 | $1,122.02 |
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 $223.87 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $223.87 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $89.13 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $331.13 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $66.07 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $44.67 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $309.03 | $537.03 | $537.03 |
Where Iowa sits
The same service costs 5.4 times more in Alabama 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
AL $8,312MT $1,553
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.