How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,445 to $11,749Professionalmedian $3,162 · 10th to 90th $1,778 to $4,571
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 $2,570.40 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,570.40 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,479.11 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $9,332.54 Typical High $10,232.93 | Facility | None | $7,413.10 | $9,332.54 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $4,570.88 | Professional | None | $3,162.28 | $3,715.35 | $4,570.88 |
Hally Health Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,513.56 | $2,511.89 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $1,445.44 Median $3,715.35 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,715.35 | $8,128.31 |
Medica Setting Professional Modifier None Typical Low $1,862.09 Median $3,630.78 Typical High $12,022.64 | Professional | None | $1,862.09 | $3,630.78 | $12,022.64 |
Midlands Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $4,466.84 | Professional | None | $3,162.28 | $3,715.35 | $4,466.84 |
Midlands Setting Facility Modifier None Typical Low $7,413.10 Median $9,332.54 Typical High $10,232.93 | Facility | None | $7,413.10 | $9,332.54 | $10,232.93 |
Midlands Setting Professional Modifier None Typical Low $3,235.94 Median $3,548.13 Typical High $5,623.41 | Professional | None | $3,235.94 | $3,548.13 | $5,623.41 |
Oscar Health Setting Professional Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,884.03 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $5,011.87 Typical High $19,054.61 | Facility | None | $1,584.89 | $5,011.87 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,659.59 | $2,511.89 | $4,466.84 |
Wellmark Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,630.78 | Professional | None | $3,090.30 | $3,090.30 | $3,630.78 |
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 $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $741.31 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $295.12 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,122.02 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $223.87 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $147.91 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,819.70 | $1,819.70 |
Where Iowa sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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
AK $16,761KY $3,604
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.