How much rates vary
Facilitymedian $603 · 10th to 90th $200 to $1,622Professionalmedian $617 · 10th to 90th $316 to $832
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 $426.58 Median $851.14 Typical High $6,760.83 | Facility | None | $426.58 | $851.14 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $616.60 | Professional | None | $251.19 | $426.58 | $616.60 |
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 $512.86 Median $630.96 Typical High $758.58 | Professional | None | $512.86 | $630.96 | $758.58 |
Hally Health Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $537.03 | Professional | None | $251.19 | $407.38 | $537.03 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $602.56 Typical High $1,288.25 | Facility | None | $223.87 | $602.56 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $630.96 Typical High $2,238.72 | Professional | None | $323.59 | $630.96 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $741.31 | Professional | None | $524.81 | $616.60 | $741.31 |
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 $478.63 Median $741.31 Typical High $870.96 | Professional | None | $478.63 | $741.31 | $870.96 |
Oscar Health Setting Professional Modifier None Typical Low $331.13 Median $602.56 Typical High $776.25 | Professional | None | $331.13 | $602.56 | $776.25 |
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 $263.03 Median $398.11 Typical High $741.31 | Professional | None | $263.03 | $398.11 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $891.25 | Professional | None | $645.65 | $758.58 | $891.25 |
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 $134.90 Median $213.80 Typical High $234.42 | Professional | 52 · Reduced service | $134.90 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $87.10 Typical High $95.50 | Professional | 53 · Discontinued | $53.70 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $323.59 Typical High $354.81 | Professional | 54 · Surgery only | $199.53 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $64.57 Typical High $70.79 | Professional | 55 · Aftercare only | $39.81 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $42.66 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $302.00 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $186.21 | $302.00 | $331.13 |
Where Iowa sits
The same service costs 6.4 times more in Colorado 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
CO $2,602FL $408
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.