How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,148 to $14,791Professionalmedian $1,288 · 10th to 90th $692 to $1,778
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 $1,023.29 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,023.29 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $1,318.26 | Professional | None | $588.84 | $1,023.29 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $10,715.19 | Facility | None | $1,288.25 | $7,762.47 | $10,715.19 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,479.11 | $1,778.28 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,737.80 | Professional | None | $602.56 | $977.24 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $17,378.01 | Facility | None | $1,122.02 | $2,344.23 | $17,378.01 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,445.44 Typical High $4,786.30 | Professional | None | $724.44 | $1,445.44 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,445.44 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $2,290.87 Median $6,606.93 Typical High $10,715.19 | Facility | None | $2,290.87 | $6,606.93 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,479.11 | $2,238.72 |
Oscar Health Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $1,445.44 | Professional | None | $616.60 | $1,148.15 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $19,054.61 | Facility | None | $1,380.38 | $4,365.16 | $19,054.61 |
United Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,778.28 | Professional | None | $630.96 | $977.24 | $1,778.28 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,288.25 | $1,513.56 |
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 $295.12 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $295.12 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $120.23 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $446.68 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $89.13 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $58.88 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $416.87 | $724.44 | $724.44 |
Where Iowa sits
The same service costs 5.4 times more in Alaska 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
AK $11,142MT $2,070
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.