How much rates vary
Facilitymedian $794 · 10th to 90th $204 to $2,344Professionalmedian $1,023 · 10th to 90th $525 to $1,349
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 $724.44 Median $2,630.27 Typical High $6,760.83 | Facility | None | $724.44 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $724.44 Typical High $776.25 | Professional | None | $446.68 | $724.44 | $776.25 |
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 $912.01 Median $1,071.52 Typical High $1,258.93 | Professional | None | $912.01 | $1,071.52 | $1,258.93 |
Hally Health Setting Professional Modifier None Typical Low $416.87 Median $691.83 Typical High $954.99 | Professional | None | $416.87 | $691.83 | $954.99 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,000.00 Typical High $1,621.81 | Facility | None | $239.88 | $1,000.00 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $3,630.78 | Professional | None | $562.34 | $1,071.52 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,258.93 | Professional | None | $891.25 | $1,047.13 | $1,258.93 |
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 $851.14 Median $1,258.93 Typical High $1,348.96 | Professional | None | $851.14 | $1,258.93 | $1,348.96 |
Oscar Health Setting Professional Modifier None Typical Low $489.78 Median $891.25 Typical High $1,174.90 | Professional | None | $489.78 | $891.25 | $1,174.90 |
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 $457.09 Median $676.08 Typical High $1,258.93 | Professional | None | $457.09 | $676.08 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,318.26 | Professional | None | $933.25 | $1,096.48 | $1,318.26 |
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 $223.87 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $223.87 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $91.20 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $549.54 Typical High $588.84 | Professional | 54 · Surgery only | $338.84 | $549.54 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $109.65 Typical High $117.49 | Professional | 55 · Aftercare only | $67.61 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $45.71 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $512.86 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $316.23 | $512.86 | $549.54 |
Where Iowa sits
The same service costs 4.9 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 $3,107FL $640
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.