How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,288 to $8,710Professionalmedian $1,585 · 10th to 90th $912 to $2,291
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 $1,288.25 Median $5,011.87 Typical High $7,244.36 | Facility | None | $1,288.25 | $5,011.87 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $1,288.25 | Professional | None | $741.31 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,288.25 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,862.09 | $2,238.72 |
Hally Health Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,041.74 | Professional | None | $741.31 | $1,174.90 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,174.90 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,698.24 Typical High $6,025.60 | Professional | None | $912.01 | $1,698.24 | $6,025.60 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,819.70 | $2,187.76 |
Midlands Setting Facility Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,621.81 | $2,630.27 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,819.70 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $2,238.72 | Professional | None | $794.33 | $1,230.27 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
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 $371.54 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $371.54 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $147.91 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $562.34 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $112.20 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $74.13 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $524.81 | $891.25 | $891.25 |
Where Iowa sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.