How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,096 to $9,550Professionalmedian $977 · 10th to 90th $525 to $2,455
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 $851.14 Median $6,165.95 Typical High $12,589.25 | Facility | None | $851.14 | $6,165.95 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $851.14 Typical High $1,047.13 | Professional | None | $398.11 | $851.14 | $1,047.13 |
Ambetter Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $933.25 | Professional | None | $691.83 | $933.25 | $933.25 |
BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $9,549.93 Typical High $19,054.61 | Facility | None | $7,079.46 | $9,549.93 | $19,054.61 |
BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,454.71 Typical High $2,570.40 | Professional | None | $2,290.87 | $2,454.71 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,398.83 Typical High $2,951.21 | Facility | None | $1,096.48 | $2,398.83 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,023.29 | Professional | None | $812.83 | $954.99 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $8,912.51 | Facility | None | $1,071.52 | $2,137.96 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $977.24 Typical High $3,235.94 | Professional | None | $524.81 | $977.24 | $3,235.94 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,288.25 | Professional | None | $812.83 | $977.24 | $1,288.25 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $3,162.28 | Facility | None | $1,096.48 | $2,454.71 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,288.25 | Professional | None | $741.31 | $1,000.00 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $6,309.57 | Facility | None | $1,288.25 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,174.90 | Professional | None | $524.81 | $851.14 | $1,174.90 |
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 $199.53 Typical High $331.13 | Professional | 52 · Reduced service | $199.53 | $199.53 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $134.90 | Professional | 53 · Discontinued | $79.43 | $79.43 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $295.12 Typical High $501.19 | Professional | 54 · Surgery only | $295.12 | $295.12 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $100.00 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $66.07 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $275.42 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $275.42 | $275.42 | $467.74 |
Where Nebraska 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.