How much rates vary
Facilitymedian $603 · 10th to 90th $195 to $1,820Professionalmedian $646 · 10th to 90th $339 to $912
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 $446.68 Median $5,011.87 Typical High $7,943.28 | Facility | None | $446.68 | $5,011.87 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $524.81 | Professional | None | $269.15 | $446.68 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $281.84 | Facility | None | $114.82 | $218.78 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $831.76 | Professional | None | $549.54 | $676.08 | $831.76 |
Hally Health Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $630.96 | Professional | None | $263.03 | $467.74 | $630.96 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $616.60 Typical High $1,348.96 | Facility | None | $223.87 | $616.60 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $2,454.71 | Professional | None | $380.19 | $691.83 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $776.25 | Professional | None | $549.54 | $645.65 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $281.84 | Facility | None | $114.82 | $218.78 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $933.25 | Professional | None | $524.81 | $776.25 | $933.25 |
Oscar Health Setting Professional Modifier None Typical Low $323.59 Median $602.56 Typical High $812.83 | Professional | None | $323.59 | $602.56 | $812.83 |
United Setting Facility Modifier None Typical Low $223.87 Median $707.95 Typical High $1,995.26 | Facility | None | $223.87 | $707.95 | $1,995.26 |
United Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $831.76 | Professional | None | $281.84 | $436.52 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $933.25 | Professional | None | $630.96 | $741.31 | $933.25 |
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 $141.25 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $141.25 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $56.23 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $213.80 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $42.66 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $28.18 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $199.53 | $316.23 | $371.54 |
Where Iowa sits
The same service costs 6.7 times more in New York than in Florida. 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
NY $2,828FL $419
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.