How much rates vary
Facilitymedian $3,020 · 10th to 90th $1,072 to $8,710Professionalmedian $1,445 · 10th to 90th $724 to $1,905
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 $1,047.13 Median $3,548.13 Typical High $6,760.83 | Facility | None | $1,047.13 | $3,548.13 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $1,047.13 Typical High $1,047.13 | Professional | None | $602.56 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,630.27 Typical High $3,235.94 | Facility | None | $954.99 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,513.56 | $1,819.70 |
Hally Health Setting Professional Modifier None Typical Low $602.56 Median $1,023.29 Typical High $1,949.84 | Professional | None | $602.56 | $1,023.29 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,344.23 Typical High $8,912.51 | Facility | None | $1,071.52 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,548.82 Typical High $5,888.44 | Professional | None | $758.58 | $1,548.82 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,513.56 | $1,778.28 |
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 $1,288.25 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,479.11 | $2,511.89 |
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 $9,772.37 | Facility | None | $1,380.38 | $4,365.16 | $9,772.37 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,819.70 | Professional | None | $660.69 | $1,000.00 | $1,819.70 |
Wellmark Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,258.93 | $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 $302.00 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $302.00 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $120.23 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $457.09 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $91.20 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $60.26 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $426.58 | $724.44 | $724.44 |
Where Iowa sits
The same service costs 3.5 times more in Wisconsin than in Hawaii. 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 $7,283HI $2,091
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.