How much rates vary
Facilitymedian $224 · 10th to 90th $126 to $617Professionalmedian $631 · 10th to 90th $295 to $891
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 $275.42 Median $316.23 Typical High $4,365.16 | Facility | None | $275.42 | $316.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $338.84 | Professional | None | $239.88 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $616.60 | Facility | None | $123.03 | $181.97 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $831.76 | Professional | None | $524.81 | $676.08 | $831.76 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $660.69 | Facility | None | $125.89 | $407.38 | $660.69 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $776.25 Typical High $2,454.71 | Professional | None | $288.40 | $776.25 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Professional | None | $616.60 | $616.60 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $218.78 | Facility | None | $123.03 | $173.78 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $691.83 | Professional | None | $562.34 | $602.56 | $691.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $660.69 | Professional | None | $331.13 | $489.78 | $660.69 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $281.84 Median $616.60 Typical High $891.25 | Professional | None | $281.84 | $616.60 | $891.25 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $977.24 | Professional | None | $645.65 | $758.58 | $977.24 |
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 $120.23 Median $141.25 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $177.83 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $28.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $165.96 | $194.98 | $239.88 |
Where South Dakota 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.