How much rates vary
Facilitymedian $3,020 · 10th to 90th $891 to $8,710Professionalmedian $912 · 10th to 90th $468 to $1,202
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 $676.08 Median $3,981.07 Typical High $7,244.36 | Facility | None | $676.08 | $3,981.07 | $7,244.36 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $1,047.13 | Professional | None | $398.11 | $676.08 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,630.27 Typical High $3,235.94 | Facility | None | $1,096.48 | $2,630.27 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,148.15 | Professional | None | $831.76 | $977.24 | $1,148.15 |
Hally Health Setting Professional Modifier None Typical Low $389.05 Median $645.65 Typical High $1,202.26 | Professional | None | $389.05 | $645.65 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,344.23 Typical High $8,912.51 | Facility | None | $758.58 | $2,344.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $954.99 Typical High $3,235.94 | Professional | None | $489.78 | $954.99 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,148.15 | Professional | None | $831.76 | $977.24 | $1,148.15 |
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 $831.76 Median $1,000.00 Typical High $1,548.82 | Professional | None | $831.76 | $1,000.00 | $1,548.82 |
Oscar Health Setting Professional Modifier None Typical Low $407.38 Median $758.58 Typical High $954.99 | Professional | None | $407.38 | $758.58 | $954.99 |
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 $426.58 Median $645.65 Typical High $1,174.90 | Professional | None | $426.58 | $645.65 | $1,174.90 |
Wellmark Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | None | $851.14 | $851.14 | $1,000.00 |
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 $199.53 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $199.53 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $295.12 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $58.88 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $39.81 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $275.42 | $478.63 | $478.63 |
Where Iowa sits
The same service costs 5.1 times more in Wisconsin than in Montana. 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 $7,097MT $1,384
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.