How much rates vary
Facilitymedian $832 · 10th to 90th $204 to $2,344Professionalmedian $1,096 · 10th to 90th $575 to $1,514
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 $758.58 Median $2,630.27 Typical High $6,760.83 | Facility | None | $758.58 | $2,630.27 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $758.58 Typical High $831.76 | Professional | None | $478.63 | $758.58 | $831.76 |
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 $1,000.00 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,000.00 | $1,122.02 | $1,318.26 |
Hally Health Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $1,000.00 | Professional | None | $436.52 | $741.31 | $1,000.00 |
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 $602.56 Median $1,174.90 Typical High $3,890.45 | Professional | None | $602.56 | $1,174.90 | $3,890.45 |
Midlands 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 |
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 $870.96 Median $1,318.26 Typical High $1,513.56 | Professional | None | $870.96 | $1,318.26 | $1,513.56 |
Oscar Health Setting Professional Modifier None Typical Low $562.34 Median $1,047.13 Typical High $1,348.96 | Professional | None | $562.34 | $1,047.13 | $1,348.96 |
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 $489.78 Median $724.44 Typical High $1,380.38 | Professional | None | $489.78 | $724.44 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,096.48 | $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 $239.88 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $239.88 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $95.50 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $354.81 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $72.44 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $47.86 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $331.13 | $524.81 | $575.44 |
Where Iowa sits
The same service costs 5.2 times more in Connecticut than in Delaware. 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 $3,468DE $666
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.