How much rates vary
Facilitymedian $912 · 10th to 90th $204 to $3,090Professionalmedian $1,122 · 10th to 90th $575 to $1,413
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 $794.33 Median $3,388.44 Typical High $6,760.83 | Facility | None | $794.33 | $3,388.44 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $794.33 Typical High $812.83 | Professional | None | $457.09 | $794.33 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $223.87 Typical High $316.23 | Facility | None | $114.82 | $223.87 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,380.38 | Professional | None | $977.24 | $1,148.15 | $1,380.38 |
Hally Health Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,047.13 | Professional | None | $467.74 | $741.31 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,023.29 Typical High $1,621.81 | Facility | None | $239.88 | $1,023.29 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $616.60 Median $1,148.15 Typical High $3,890.45 | Professional | None | $616.60 | $1,148.15 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,380.38 | Professional | None | $977.24 | $1,148.15 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $223.87 Typical High $316.23 | Facility | None | $123.03 | $223.87 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,412.54 | Professional | None | $954.99 | $1,348.96 | $1,412.54 |
Oscar Health Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $1,230.27 | Professional | None | $524.81 | $933.25 | $1,230.27 |
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 $501.19 Median $758.58 Typical High $1,380.38 | Professional | None | $501.19 | $758.58 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,000.00 | $1,148.15 | $1,348.96 |
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 $234.42 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $234.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $158.49 Typical High $162.18 | Professional | 53 · Discontinued | $93.33 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $346.74 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $70.79 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $79.43 Typical High $81.28 | Professional | 56 · Pre-op care only | $46.77 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $323.59 | $549.54 | $562.34 |
Where Iowa sits
The same service costs 5.2 times more in Connecticut 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
CT $3,486FL $668
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.